Evidence map›Paper›PMID 36302039›Full record

ArticlePloS one2022

Polypharmacy and medical intensive care unit (MICU) admission and 10-year all-cause mortality risk among hospitalized patients with and without HIV.

Kirsha S Gordon, Kristina Crothers, Adeel A Butt, E Jennifer Edelman, Cynthia Gibert, Margaret M Pisani, Maria Rodriguez-Barradas, Christina Wyatt, Amy C Justice, Kathleen M Akgün

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 40% 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

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. 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

10 authors at 6 institutions in 1 country.

Kirsha S GordonVA Connecticut Healthcare System, West Haven, CT, United States of America.
Kristina CrothersVA Puget Sound Health Care System, Seattle, WA, United States of America.
Adeel A ButtDepartment of Medicine, Weill Cornell Medical College, New York, NY, United States of America.
E Jennifer EdelmanYale School of Medicine, New Haven, CT, United States of America.
Cynthia GibertGeorge Washington University School of Medicine, Washington, DC, United States of America.
Margaret M PisaniYale School of Medicine, New Haven, CT, United States of America.
Maria Rodriguez-BarradasMichael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, TX, United States of America.
Christina WyattDuke University School of Medicine, Durham, NC, United States of America.
Amy C JusticeVA Connecticut Healthcare System, West Haven, CT, United States of America.
Kathleen M AkgünVA Connecticut Healthcare System, West Haven, CT, United States of America.ORCID 0000-0003-2623-7463
Yale University · USCornell University · USDuke University · USGeorge Washington University · USMichael E. DeBakey VA Medical Center · USUniversity of Washington · US

Funding

Alcohol Associated Outcomes Among HIV+/- Aging VeteransU10AA013566 · NIAAA · YALE UNIVERSITY · PI JUSTICE, AMY CAROLINE · 2006 to 2010
$12.7M
Alcohol and Multisubstance Use in the Veterans Aging Cohort StudyU01AA020790 · NIAAA · YALE UNIVERSITY · PI JUSTICE, AMY CAROLINE · 2011 to 2020
$7.7M
Sex Disparities in Overall Response to ART Among HIV Infected IndividualsU24AA020794 · NIAAA · YALE UNIVERSITY · PI JUSTICE, AMY CAROLINE · 2011 to 2020
$5.5M
Integrated Stepped Care for Unhealthy Alcohol Use in HIVU01AA020795 · NIAAA · YALE UNIVERSITY · PI FIELLIN, DAVID · 2011 to 2020
$5.2M
The Operations Research Collaboration for Alcohol Abuse and AIDS: ORCAAAU24AA022007 · NIAAA · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI BRAITHWAITE, RONALD SCOTT · 2012 to 2016
$3.4M
Translational Research on Alcohol, Immunodeficiency, and Aging In COMpAAASU24AA022001 · NIAAA · YALE UNIVERSITY · PI BRANDT, CYNTHIA A. · 2012 to 2020
$3.2M
Consortium to improve Outcomes in HIV/AIDS, Alcohol, Aging & multi-Substance useU01AA020799 · NIAAA · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI BRAITHWAITE, RONALD SCOTT · 2011 to 2020
$2.1M
HSRD VA SDR 02-237NIAAA NIH HHS U01 AA020790NIAAA NIH HHS U01 AA020795NIAAA NIH HHS U01 AA020799NIAAA NIH HHS U10 AA013566NIAAA NIH HHS U24 AA020794NIAAA NIH HHS U24 AA022001NIAAA NIH HHS U24 AA022007
6 · The paper itself

Abstract

objectiveMedical intensive care unit (MICU) admissions have been declining in people with HIV infection (PWH), but frequency of outpatient polypharmacy (prescription of ≥5 chronic medications) has increased. Among those hospitalized, we examined whether outpatient polypharmacy is associated with subsequent 1-year MICU admission or 10-year all-cause mortality, and if the association varies by HIV status.

designRetrospective cohort study.

methodsUsing a national electronic health record cohort of Veterans in care, we ascertained outpatient polypharmacy during fiscal year (FY) 2009 and followed patients for 1-year MICU admission and 10-year mortality. We assessed associations of any polypharmacy (yes/no and categorized ≤4, 5-7, 8-9, and ≥10 medications) with 1-year MICU admission and 10-year mortality using logistic and Cox regressions, respectively, adjusted for demographics, HIV status, substance use, and severity of illness.

resultsAmong 9898 patients (1811 PWH) hospitalized in FY2010, prior outpatient polypharmacy was common (51%). Within 1 year, 1532 (15%) had a MICU admission and within 10 years, 4585 (46%) died. Polypharmacy was associated with increased odds of 1-year MICU admission, in both unadjusted (odds ratio (OR) 1.36 95% CI: (1.22, 1.52)) and adjusted models, aOR (95% CI) = 1.28 (1.14, 1.43) and with 10-year mortality in unadjusted, hazard ratio (HR) (95% CI) = 1.40 (1.32, 1.48), and adjusted models, HR (95% CI) = 1.26 (1.19, 1.34). Increasing levels of polypharmacy demonstrated a dose-response with both outcomes and by HIV status, with a stronger association among PWH.

conclusionsAmong hospitalized patients, prior outpatient polypharmacy was associated with 1-year MICU admission and 10-year all-cause mortality after adjusting for severity of illness in PWH and PWoH.

Indexed as

HIV InfectionsPolypharmacyHospitalizationHumansIntensive Care UnitsRetrospective Studies

Identifiers

PMID36302039
PMCPMC9612570
OpenAlexW4307412541

What OpenQuestion holds

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LicenceCC0
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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.