Adverse clinical outcomes associated with drug-related hospitalizations in people with dementia

Abstract

ABSTRACTBackgroundThis study aimed to determine the clinical impact associated with adverse drug reactions (ADRs) in patients with dementia.Research design and methodsThis case-control, propensity score-matched study utilized administrative data of people with dementia admitted to major public hospitals in Tasmania, Australia, from July 2010 to December 2019.ResultsAcute renal failure constituted the most common ADR. The length of hospital stay was greater for people with an ADR index admission, versus non-ADR index admission (median [IQR]: 9 [4–18] versus 6 [2–12]; p < 0.001). In-hospital mortality and combined in-hospital and post-hospital mortality within 30, 60 and 90 days were higher for those whose index admission was ADR-related (in-hospital: HR 1.40, 95% CI 1.11–1.77, p-value <0.001; 30 days: HR 1.25, 95% CI 1.05–1.49, p-value <0.001; 60 days: HR 1.27, 95% CI 1.08–1.49, p-value <0.001; 90 days: HR 1.29, 95% CI 1.10–1.50, p-value <0.001). Subsequent ADR admission within 30, 60 and 90 days of index discharge was 9 to 10 times greater for people with dementia (30 days: OR 10.0, 95% CI 6.04–16.8, p-value <0.001; 60 days: OR 8.96, 95% CI 5.57–14.4, p-value <0.001; 90 days: OR 9.31, 95% CI 5.79–14.9, p-value <0.001).ConclusionSafe prescribing and vigilant monitoring of ADRs is pivotal to mitigate adverse outcomes in people with dementia.