Association between perioperative potentially inappropriate medication and short-term adverse postoperative outcomes in elderly patients

doi:10.19803/j.1672-8629.20260218

Abstract

Abstract: Objective To analyze the association between perioperative PIM exposure levels and postoperative complications in order to provide evidence for decision-making regarding precise medication interventions and optimization of surgical quality management in elderly patients. Methods A single-center retrospective cohort design was employed. Patients ages 65 and older undergoing elective non-cardiac surgery at a hospital in Nanjing between December 2022 and March 2025 were included. Perioperative PIMs were evaluated based on the Beers criteria, and short-term exposure evaluation indicators were established. The outcome referred to the occurrence of complications within 30 days postoperatively. Multivariable logistic regression analysis was conducted to examine the impact of preoperative and intraoperative PIM exposure on the risk of postoperative complications. Results A total of 696 patients were enrolled in this study, 284 of whom (40.80%) were exposed to PIMs preoperatively. Postoperative complications within 30 days occurred in 154 patients (22.13%) of the entire cohort. Multivariable logistic regression analysis found that preoperative PIM exposure was a significant contributor to postoperative adverse drug reactions [Odds Ratio (OR)=1.651, P=0.019]. An increase in preoperative PIM exposure levels was associated with an incremental risk of overall postoperative complications (OR=1.277, P=0.012). In addition, 238 patients (34.20%) were exposed to PIMs both preoperatively and intraoperatively. Interaction analysis indicated that combined preoperative-intraoperative PIM exposure had a synergistic effect on the risk of postoperative complications, with a more significant impact than exposure during either period alone (OR=6.585, P= 0.003). Conclusion Preoperative PIM exposure is common among elderly surgical patients and associated with an increased risk of postoperative complications. Additional intraoperative PIM exposure can exacerbate the negative impact on postoperative recovery. Routine and dynamic monitoring of perioperative PIMs is conducive to prognostic risk stratifi-cation and may serve as a potential intervention target for improving postoperative outcomes.

Key words: Potentially Inappropriate Medication, Perio-perative Period, Postoperative Complications, Single-Center Retrospective Cohort Design, Elder Patients

CLC Number:

R994.11

Xu Ling, Li Jiajie, Li Xin, Gu Kai. Association between perioperative potentially inappropriate medication and short-term adverse postoperative outcomes in elderly patients[J]. Chinese Journal of Pharmacovigilance, 2026, 23(7): 802-808.

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