Association of preoperative medication with postoperative length of stay in elderly patients undergoing hip fracture surgery.
BACKGROUND
For elderly patients who are about to undergo surgery, research on the effects of preoperative medication on postoperative outcomes is rare, especially preoperative discontinuation-requiring medication (PDRM) which needed to be discontinued because of its increased risk of postoperative complications.


AIM
To investigate whether preoperative medication (PDRM and polypharmacy) is associated with postoperative length of hospital stay (LOS) in elderly patients undergoing hip fracture surgery.


METHODS
Patients aged ≥ 65 who were scheduled for hip (limited to femoral tuberosity) fracture surgery were included. Baseline characteristics, preoperative medication and postoperative LOS were collected from the electronic medical record. The primary outcome was postoperative LOS.


RESULTS
A total of 369 hip fracture patients were included. There were 188 and 122 patients exposed to PDRM and polypharmacy, respectively. Multivariate analysis models were constructed using significant factors for prolonged postoperative hospital stay from univariate analysis: Model I (body mass index (BMI), Charlson comorbidity index (CCI) ≥ 7, creatinine clearance rate (Ccr) < 60 and PDRM) and Model II (BMI, Ccr ≥ 7, Ccr < 60 and polypharmacy). CCI was the most significant factor. Its adjusted odds ratio was as large as 2.7 and attributable risk was 63%. In preoperative medication use, both polypharmacy and PDRM showed significant association with postoperative LOS.


CONCLUSION
The present study supported the impact of PDRM on postoperative LOS in geriatric hip fracture patients. The results added a further aspect to preoperative medication optimization in elderly patients undergoing hip fracture surgery.
['Shen|Jianghua|J|http://orcid.org/0000-0002-9965-1553', 'Yu|Yahui|Y|', 'Wang|Chaodong|C|', 'Chu|Yanqi|Y|', 'Yan|Suying|S|']
D000368:Aged D006620:Hip Fractures D006801:Humans D007902:Length of Stay D016017:Odds Ratio D011183:Postoperative Complications D012189:Retrospective Studies D012307:Risk Factors
Preoperative medication Postoperative length of stay Elderly patients Hip fracture surgery Preoperative discontinuation-requiring medication Polypharmacy