Year: 2025
Type: conference-paper
Study design: Observational Study
Abstract: Background and Importance Medication review aims to address inappropriate prescribing, and patient stratification is crucial for effective resource utilisation in the emergency department (ED). The inconsistent impact of medication review on adverse clinical outcomes suggests that stratification based solely on age and number of medications, without considering disease burden, is inadequate. Aim and Objectives The objective was to investigate the associations between FI-OutRef (a frailty index based on number of abnormal routine blood tests) and medication use with readmission and mortality. Material and Methods This was a single-centre observational register-based cohort study of patients presenting to the ED between November 2013 and March 2017. Patients were followed for readmission or mortality after hospital discharge. The study included acutely admitted medical patients who had routine blood tests analysed. Patients were excluded if they were <18 years old, were missing ≥8 standard biomarkers, or died during index admission. Routine blood tests included a panel of 17 standard biomarkers, and FI-OutRef was defined as the number of biomarkers outside reference ranges. Medications were included if redeemed within 4 months prior to index admission. The outcome was time to readmission or mortality within 90 days of hospital discharge. Results Among 27,873 acutely admitted medical patients (52.5% female, median age 59.3 years (IQR: 41.7–74.5)), increasing FI-OutRef and medication use were individually associated with increasing risks of readmission and mortality. Increasing medication use within each FI-OutRef group was also generally associated with increasing risks of readmission and mortality, but the impact of medication use was most pronounced in patients with FI-OutRef ≤4. Conclusion and Relevance Both FI-OutRef and medication use yield relevant information about adverse clinical outcomes and can easily be incorporated within the electronic medical record system to identify patients who would benefit most from medication review. References and/or Acknowledgements Conflict of Interest Corporate sponsored research or other substantive relationships: Ove Andersen is named inventor on patents covering suPAR, owned by the Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark. The remaining authors declare no conflicts of interest.
Authors: LWS Christensen, LJH Rasmussen, E Iversen, KP Dalhoff, O Andersen, MB Houlind, HG Juul-Larsen
Language: English
Subfield: Geriatrics and Gerontology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W4408376247