Association between Acute Geriatric Syndromes and Medication-Related Hospital Admissions

Peter C Wierenga,Susanne M Smorenburg,Sophia E J A De Rooij,Juliette L Parlevliet,Barbara C Van Munster,Sharon K Inouye,Bianca M Buurman

doi:10.1007/bf03262284

Abstract

Association between Acute Geriatric Syndromes and Medication-Related Hospital Admissions

Highlights

Patients are at a four-fold higher risk of adverse drug events (ADEs) and drug related hospitalization
Over 25% had an ADE present at admission, 26% presented with delirium and 12% with a fall
Geriatric syndromes are understood to have the following features: they occur in older, often vulnerable persons; precipitated by one or more acute triggers, they are multifactorial in aetiology; they seldom follow a typically episodic course and they frequently lead to persistent functional impairment.8;9 An acute illness leading to hospitalization is often accompanied by one or more geriatric syndromes, especially falls and delirium (15–30% and 10%, respectively).[10,11,12,13]

Summary

Introduction

Patients are at a four-fold higher risk of adverse drug events (ADEs) and drug related hospitalization. ADEs are the most frequent type of adverse events occurring in medical inpatients and a considerable part of hospital admissions are related to ADEs. ADEs have been associated with unnecessary hospital admission.[1] Compared with younger patients, patients aged 65 years or older are at a four-fold higher risk for ADEs.[2] This can be ascribed to their comorbidities, complex care, presence of cognitive, social and functional limitations, use of multiple drugs, and altered pharmacokinetics and pharmacodynamics.3;4 A recent systematic review showed that the odds of being hospitalized by ADE-related problems is four times higher for elderly persons (16.6% vs 4.1%).5Approximately 50% of ADEs are preventable,[4,5] and can be resolved if detected in time. Geriatric syndromes are understood to have the following features: they occur in older, often vulnerable persons; precipitated by one or more acute triggers, they are multifactorial in aetiology; they seldom follow a typically episodic course and they frequently lead to persistent functional impairment.8;9 An acute illness leading to hospitalization is often accompanied by one or more geriatric syndromes, especially falls and delirium (15–30% and 10%, respectively).[10,11,12,13] These geriatric syndromes are associated with substantially poorer discharge outcomes such as functional decline, institutionalization, and mortality.[14]

Objectives

Methods

Results

Discussion

Conclusion