PMID- 21221958 OWN - NLM STAT- MEDLINE DCOM- 20110810 LR - 20220409 IS - 1432-1041 (Electronic) IS - 0031-6970 (Linking) VI - 67 IP - 5 DP - 2011 May TI - Polypharmacy, length of hospital stay, and in-hospital mortality among elderly patients in internal medicine wards. The REPOSI study. PG - 507-19 LID - 10.1007/s00228-010-0977-0 [doi] AB - PURPOSES: We evaluated the prevalence and factors associated with polypharmacy and investigated the role of polypharmacy as a predictor of length of hospital stay and in-hospital mortality. METHODS: Thirty-eight internal medicine wards in Italy participated in the Registro Politerapie SIMI (REPOSI) study during 2008. One thousand three hundred and thirty-two in-patients aged >/=65 years were enrolled. Polypharmacy was defined as the concomitant use of five or more medications. Linear regression analyses were used to evaluate predictors of length of hospital stay and logistic regression models for predictors of in-hospital mortality. Age, sex, Charlson comorbidity index, polypharmacy, and number of in-hospital clinical adverse events (AEs) were used as possible confounders. RESULTS: The prevalence of polypharmacy was 51.9% at hospital admission and 67.0% at discharge. Age, number of drugs at admission, hypertension, ischemic heart disease, heart failure, and chronic obstructive pulmonary disease were independently associated with polypharmacy at discharge. In multivariate analysis, the occurrence of at least one AE while in hospital was the only predictor of prolonged hospitalization (each new AE prolonged hospital stay by 3.57 days, p < 0.0001). Age [odds ratio (OR) 1.04; 95% confidence interval (CI) 1.01-1.08; p = 0.02), comorbidities (OR 1.18; 95% CI 1.12-1.24; p < 0.0001), and AEs (OR 6.80; 95% CI 3.58-12.9; p < 0.0001) were significantly associated with in-hospital mortality. CONCLUSIONS: Although most elderly in-patients receive polypharmacy, in this study, it was not associated with any hospital outcome. However, AEs were strongly correlated with a longer hospital stay and higher mortality risk. FAU - Nobili, Alessandro AU - Nobili A AD - Laboratory for Quality Assessment of Geriatric Therapies and Services, Mario Negri Institute for Pharmacological Research, via Giuseppe La Masa, 19, 20156 Milan, Italy. nobili@marionegri.it FAU - Licata, Giuseppe AU - Licata G FAU - Salerno, Francesco AU - Salerno F FAU - Pasina, Luca AU - Pasina L FAU - Tettamanti, Mauro AU - Tettamanti M FAU - Franchi, Carlotta AU - Franchi C FAU - De Vittorio, Luigi AU - De Vittorio L FAU - Marengoni, Alessandra AU - Marengoni A FAU - Corrao, Salvatore AU - Corrao S FAU - Iorio, Alfonso AU - Iorio A FAU - Marcucci, Maura AU - Marcucci M FAU - Mannucci, Pier Mannuccio AU - Mannucci PM CN - SIMI Investigators LA - eng PT - Journal Article DEP - 20110111 PL - Germany TA - Eur J Clin Pharmacol JT - European journal of clinical pharmacology JID - 1256165 SB - IM MH - Aged MH - Aged, 80 and over MH - Cohort Studies MH - Drug Prescriptions MH - Female MH - *Hospital Mortality MH - *Hospitalization MH - Humans MH - Internal Medicine/methods/*standards MH - Italy/epidemiology MH - Linear Models MH - Logistic Models MH - Male MH - *Polypharmacy MH - Practice Patterns, Physicians' MH - Prevalence MH - Prospective Studies FIR - Mannucci, Pier Mannuccio IR - Mannucci PM FIR - Tedeschi, Alberto IR - Tedeschi A FIR - Rossio, Raffaella IR - Rossio R FIR - Moreo, Guido IR - Moreo G FIR - Ferrari, Barbara IR - Ferrari B FIR - Masala, Cesare IR - Masala C FIR - Mammarella, Antonio IR - Mammarella A FIR - Raparelli, Valeria IR - Raparelli V FIR - Carulli, Nicola IR - Carulli N FIR - Rondinella, Stefania IR - Rondinella S FIR - Giannico, Iolanda IR - Giannico I FIR - Rasciti, Leonardo IR - Rasciti L FIR - Gualandi, Silvia IR - Gualandi S FIR - Monzani, Valter IR - Monzani V FIR - Savojardo, Valeria IR - Savojardo V FIR - Cappellini, Maria Domenica IR - Cappellini MD FIR - Fabio, Giovanna IR - Fabio G FIR - Cantoni, Flavio IR - Cantoni F FIR - Dallegri, Franco IR - Dallegri F FIR - Ottonello, Luciano IR - Ottonello L FIR - Quercioli, Alessandra IR - Quercioli A FIR - Barreca, Alessandra IR - Barreca A FIR - Utili, Riccardo IR - Utili R FIR - Durante-Mangoni, Emanuele IR - Durante-Mangoni E FIR - Pinto, Daniela IR - Pinto D FIR - Manfredini, Roberto IR - Manfredini R FIR - Incasa, Elena IR - Incasa E FIR - Rizzioli, Emanuela IR - Rizzioli E FIR - Vanoli, Massimo IR - Vanoli M FIR - Casella, Gianluca IR - Casella G FIR - Musca, Giuseppe IR - Musca G FIR - Cuccurullo, Olga IR - Cuccurullo O FIR - Gasbarrone, Laura IR - Gasbarrone L FIR - Famularo, Giuseppe IR - Famularo G FIR - Sajeva, Maria Rosaria IR - Sajeva MR FIR - Picardi, Antonio IR - Picardi A FIR - Hila, Dritan IR - Hila D FIR - Rozzini, Renzo IR - Rozzini R FIR - Giordano, Alessandro IR - Giordano A FIR - Sacco, Andrea IR - Sacco A FIR - Bonelli, Antonio IR - Bonelli A FIR - Dentamaro, Gaetano IR - Dentamaro G FIR - Salerno, Francesco IR - Salerno F FIR - Monti, Valentina IR - Monti V FIR - Cazzaniga, Massimo IR - Cazzaniga M FIR - Nielsen, Ingrid IR - Nielsen I FIR - Gaudenzi, Piergiorgio IR - Gaudenzi P FIR - Giusto, Lisa IR - Giusto L FIR - Rotazione, Alta IR - Rotazione A FIR - Rosei, Enrico Agabiti IR - Rosei EA FIR - Rizzoni, Damiano IR - Rizzoni D FIR - Castoldi, Luana IR - Castoldi L FIR - Mari, Daniela IR - Mari D FIR - Micale, Giuliana IR - Micale G FIR - Altomare, Emanuele IR - Altomare E FIR - Serviddio, Gaetano IR - Serviddio G FIR - Salvatore, Santina IR - Salvatore S FIR - Longhini, Carlo IR - Longhini C FIR - Molino, Cristian IR - Molino C FIR - Delitalia, Giuseppe IR - Delitalia G FIR - Deidda, Silvia IR - Deidda S FIR - Cuccuru, Luciana Maria IR - Cuccuru LM FIR - Benetti, Giampiero IR - Benetti G FIR - Quagliolo, Michela IR - Quagliolo M FIR - Centenaro, Giuseppe Riccardo IR - Centenaro GR FIR - Auteri, Alberto IR - Auteri A FIR - Pasqui, Anna Laura IR - Pasqui AL FIR - Puccetti, Luca IR - Puccetti L FIR - Balduini, Carlo IR - Balduini C FIR - Bertolino, Giampiera IR - Bertolino G FIR - Cavallo, Piergiorgio IR - Cavallo P FIR - Ronchi, Esio IR - Ronchi E FIR - Bertolini, Daniele IR - Bertolini D FIR - Lucio Liberato, Nicola IR - Lucio Liberato N FIR - Carlo Mira, Ospedale IR - Carlo Mira O FIR - Perciccante, Antonio IR - Perciccante A FIR - Coralli, Alessia IR - Coralli A FIR - Anastasio, Luigi IR - Anastasio L FIR - Bertucci, Leonardo IR - Bertucci L FIR - Agnelli, Giancarlo IR - Agnelli G FIR - Macura, Ana IR - Macura A FIR - Iorio, Alfonso IR - Iorio A FIR - Marcucci, Maura IR - Marcucci M FIR - Morabito, Cosimo IR - Morabito C FIR - Fava, Roberto IR - Fava R FIR - Licata, Giuseppe IR - Licata G FIR - Tuttolomondo, Antonino IR - Tuttolomondo A FIR - Di Sciacca, Riccardo IR - Di Sciacca R FIR - Macchini, Luisa IR - Macchini L FIR - Realdi, Anna IR - Realdi A FIR - Cricco, Luigi IR - Cricco L FIR - Fiorentini, Alessandra IR - Fiorentini A FIR - Tofi, Cristina IR - Tofi C FIR - Cagnoni, Carlo IR - Cagnoni C FIR - Manucra, Antonio IR - Manucra A FIR - Romanelli, Giuseppe IR - Romanelli G FIR - Marengoni, Alessandra IR - Marengoni A FIR - Bonometti, Francesca IR - Bonometti F FIR - Cortellaro, Michele IR - Cortellaro M FIR - Meroni, Maria Rachele IR - Meroni MR FIR - Magenta, Marina IR - Magenta M FIR - Vergani, Carlo IR - Vergani C FIR - Rossi, Dionigi Paolo IR - Rossi DP FIR - Spirito, Valentina IR - Spirito V FIR - Noce, Damia IR - Noce D FIR - Bonazzi, Jacopo IR - Bonazzi J FIR - Lombardo, Rossana IR - Lombardo R FIR - De Vittorio, Luigi IR - De Vittorio L EDAT- 2011/01/12 06:00 MHDA- 2011/08/11 06:00 CRDT- 2011/01/12 06:00 PHST- 2010/09/01 00:00 [received] PHST- 2010/12/12 00:00 [accepted] PHST- 2011/01/12 06:00 [entrez] PHST- 2011/01/12 06:00 [pubmed] PHST- 2011/08/11 06:00 [medline] AID - 10.1007/s00228-010-0977-0 [doi] PST - ppublish SO - Eur J Clin Pharmacol. 2011 May;67(5):507-19. doi: 10.1007/s00228-010-0977-0. Epub 2011 Jan 11.