Objective to investigate the effect of potentially inappropriate medications (PIMs) on inpatient falls and to identify whether PIMs as defined by STOPPFall or the designated section K for falls of STOPP v2 have a stronger association with inpatient falls when compared to the general tool STOPP v2. Methods a retrospective observational matching study using an electronic health records dataset of patients (≥70 years) admitted to an academic hospital (2015–19), including free text to identify inpatient falls. PIMs were identified using the STOPP v2, section K of STOPP v2 and STOPPFall. We first matched admissions with PIMs to those without PIMs on confounding factors. We then applied multinomial logistic regression analysis and Cox proportional hazards analysis on the matched datasets to identify effects of PIMs on inpatient falls. Results the dataset included 16,678 hospital admissions, with a mean age of 77.2 years. Inpatient falls occurred during 446 (2.7%) admissions. Adjusted odds ratio (OR) (95% confidence interval (CI)) for the association between PIM exposure and falls were 7.9 (6.1–10.3) for STOPP section K, 2.2 (2.0–2.5) for STOPP and 1.4 (1.3–1.5) for STOPPFall. Adjusted hazard ratio (HR) (95% CI) for the effect on time to first fall were 2.8 (2.3–3.5) for STOPP section K, 1.5 (1.3–1.6) for STOPP and 1.3 (1.2–1.5) for STOPPFall. Conclusions we identified an independent association of PIMs on inpatient falls for all applied (de)prescribing tools. The strongest effect was identified for STOPP section K, which is restricted to high-risk medication for falls. Our results suggest that decreasing PIM exposure during hospital stay might benefit fall prevention, but intervention studies are warranted.

中文翻译：

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住院期间可能不适当的药物及其对跌倒的影响

目的调查潜在不适当药物 (PIM) 对住院患者跌倒的影响，并确定与通用工具 STOPP v2 相比，由 STOPPFall 定义的 PIM 或针对 STOPP v2 跌倒指定的第 K 部分是否与住院患者跌倒有更强的关联。方法 一项回顾性观察匹配研究，使用学术型医院（2015-19 年）住院患者（≥70 岁）的电子健康记录数据集，包括用于识别住院跌倒的自由文本。使用 STOPP v2、STOPP v2 的 K 部分和 STOPPFall 识别 PIM。我们首先根据混杂因素将有 PIM 的录取与没有 PIM 的录取进行匹配。然后，我们对匹配的数据集应用多项逻辑回归分析和 Cox 比例风险分析，以确定 PIM 对住院患者跌倒的影响。结果数据集包括 16,678 名住院患者，平均年龄为 77.2 岁。在 446 人（2.7%）入院期间发生了住院病人跌倒。PIM 暴露与跌倒之间关联的调整优势比 (OR) (95% 置信区间 (CI)) 对于 STOPP 部分 K 为 7.9 (6.1-10.3)，对于 STOPP 为 2.2 (2.0-2.5) 和 1.4 (1.3-1.5)为 STOPPfall。STOPP K 部分的调整后风险比 (HR) (95% CI) 为 2.8 (2.3-3.5)，STOPP 为 1.5 (1.3-1.6)，STOPPall 为 1.3 (1.2-1.5)。结论 我们确定了所有应用（取消）处方工具的 PIM 与住院患者跌倒的独立关联。STOPP 部分 K 的效果最强，该部分仅限于跌倒的高风险药物。我们的研究结果表明，在住院期间减少 PIM 暴露可能有利于预防跌倒，