Potentially Inappropriate Medication Administration Is Associated With Adverse Postoperative Outcomes in Older...

Area of Science:

• Geriatric Medicine
• Surgical Outcomes
• Pharmacology

Background:

• The American Geriatrics Society (AGS) Beers Criteria identifies potentially inappropriate medications (PIMs) for older adults.
• The impact of PIMs on frail or cognitively impaired surgical patients is not well understood.
• Poor outcomes are common in these vulnerable surgical populations.

Purpose of the Study:

• To determine if perioperative PIM administration is linked to adverse outcomes in geriatric surgical patients.
• To specifically evaluate the association between PIMs and outcomes in frail or cognitively impaired subgroups.

Main Methods:

• Retrospective cohort study of patients aged 65+ undergoing elective surgery (February 2018 - January 2020).
• Frailty assessed by Edmonton Frail Scale (≥8), cognitive impairment by Mini-Cog (0-2).
• Compared outcomes (length of stay, discharge disposition) between patients receiving PIMs (PIM+) and those not (PIM-).

Main Results:

• 69.3% of 1627 patients received at least one PIM.
• PIM administration was associated with a longer hospital length of stay (LOS) (4.93 days vs. 3.56 days, P < .001).
• Frail patients receiving PIMs had a significantly longer LOS (6.33 days vs. 4.48 days, P = .02).

Conclusions:

• Perioperative PIM use is prevalent in older surgical patients, including frail and cognitively impaired individuals.
• PIM administration is associated with increased hospital LOS, particularly in frail patients.
• No significant association was found between PIM use and discharge disposition.