Impact of Number of Drug Types on Clinical Outcome in Patients with Acute Hip Fracture

Abstract

Objectives: This study aims to investigate the impact of the number of drug types on clinical outcomes for patients with acute hip fracture. Designs: This is a retrospective cross-sectional study. Setting: A hospital-based database constructed by the Japan Medical Data Center. Participants: Consecutive patients exhibiting acute hip fractures on admission between April 2014 and November 2017 were included. Measurements: Relationships among the numbers of varying drug types of ≥6 and ≤5 as well as clinical outcomes were analyzed in 11,073 patients aged ≥65 years. The primary outcome was defined as the Barthel Index efficiency, with the secondary outcome being the length of hospital stay. Results: Median Barthel Index scores at admission and discharge were 5 (interquartile range: 5–20) and 50 (interquartile range: 20–85). The Barthel Index efficiency was significantly higher in the group having received 5 or fewer drug variations taken (1.45 ± 1.77) than in the group receiving 6 or more drug types taken (0.94 ± 1.18) during hospital stays (p < 0.001). The length of hospital stay was significantly shorter in the group receiving 5 or fewer drug types taken (29.9 ± 23.8) than in the group having 6 or more drug types taken (44.3 ± 30.3) during hospital stays (p < 0.001), with the latter number being independently associated with the Barthel Index efficiency and length of hospital stay. Conclusions: Number of drug types of 6 or more were associated with lower Barthel Index efficiency and longer lengths of hospital stays.