Evidence map›Paper›PMID 32306300›Full record

ArticleDrugs - real world outcomes2020

Potentially Inappropriate Medication Use in Older Adults in the Preoperative Period: A Retrospective Study of a Noncardiac Surgery Cohort.

Marie-France Forget, Emily Gibson McDonald, Astrid Bicamumpaka Shema, Todd Campbell Lee, Han Ting Wang

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Drugs - real world outcomes, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 3 pooled it
0.8field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 3 syntheses or guidelines pooled it, 20 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Review
  5. Article
  6. Article
  7. Article
  8. Geriatric assessment and medical preoperative screening (GrAMPS) program for older hernia patients.Hernia : the journal of hernias and abdominal wall surgery · 2022
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 1 country.

Marie-France ForgetDivision of Geriatric Medicine, Department of Medicine, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada. marie-france.forget@umontreal.ca.ORCID http://orcid.org/0000-0002-1102-1750
Emily Gibson McDonaldDivision of General Internal Medicine, Department of Medicine, McGill University Health Center, Montreal, QC, Canada.
Astrid Bicamumpaka ShemaUniversité de Montréal, Montreal, QC, Canada.
Todd Campbell LeeDivision of General Internal Medicine, Department of Medicine, McGill University Health Center, Montreal, QC, Canada.
Han Ting WangDivision of Internal and Critical Care Medicine, Department of Medicine, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, QC, Canada.
McGill University Health Centre · CACentre Hospitalier de l’Université de Montréal · CAHôpital Maisonneuve-Rosemont · CAUniversité de Montréal · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFew studies have evaluated the prevalence of potentially inappropriate medications (PIMs) and its association with postoperative outcomes in a geriatric population in the preoperative setting.

objectivesThe purpose of this study was to evaluate the prevalence of PIMs in an older elective surgery population and to explore associations between PIMs and postoperative length of stay (LOS) and emergency department (ED) visits in the 90 days post hospital discharge, depending on frailty status. METHODOLOGY: We performed a retrospective cohort study of older adults awaiting major elective noncardiac surgery and undergoing an evaluation in the preoperative clinic at a tertiary academic center between 2017 and 2018. We identified PIMs using MedSafer, a software tool built to improve the safety of prescribing. Frailty status was assessed using the 7-point Clinical Frailty Scale. We estimated the association between PIMs and postoperative LOS and ED visits in the 90 days post hospital discharge.

resultsThe MedSafer software generated 394 recommendations on PIMs in 1619 medications for 252 patients. In total, 197 (78%) patients had at least one PIM. The cohort included 138 (51%) robust, 87 (32.2%) vulnerable and 45 (16.7%) frail patients. The association between PIMs and LOS was not significant for the robust and frail subgroups. For the vulnerable patients, every additional PIM increased LOS by 20% (incidence rate ratio 1.20; 95% confidence interval 0.90-1.44; p = 0.089) without reaching statistical significance. No association was found between PIMs and ED visits.

conclusionPIMs identified by the MedSafer software were prevalent. Preoperative evaluation represents an opportunity to plan deprescribing of PIMs.

Identifiers

PMID32306300
PMCPMC7221107
OpenAlexW3016701316

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.