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Prescription-based ...
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Gedeborg, RolfUppsala universitet,Anestesiologi och intensivvård
(författare)
Prescription-based prediction of baseline mortality risk among older men
- Artikel/kapitelEngelska2020
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2020-10-29
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Public Library of Science (PLoS),2020
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electronicrdacarrier
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LIBRIS-ID:oai:DiVA.org:uu-429986
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-429986URI
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https://doi.org/10.1371/journal.pone.0241439DOI
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Språk:engelska
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Sammanfattning på:engelska
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BACKGROUND: Understanding the association between patients' history of prescribed medications and mortality rate could optimize characterization of baseline risk when the Charlson Comorbidity Index is insufficient.METHODS: Using a Swedish cohort of men selected randomly as controls to men with prostate cancer diagnosed 2007-2013, we estimated the association between medications prescribed during the previous year and mortality rates, using Cox regression stratified for age.RESULTS: Among the 326,450 older men with median age of 69 years included in this study, 73% were categorized as free of comorbidity according to the Charlson Comorbidity Index; however, 84% had received at least one prescription during the year preceding the follow-up. This was associated with a 60% overall increase in mortality rate (hazard ratio [HR] = 1.60, 95% confidence interval [CI] 1.56 to 1.64). Some drugs that were unexpectedly associated with mortality included locally acting antacids (HR = 4.7, 95% CI 4.4 to 5.1), propulsives (HR = 4.7, 95% CI 4.4 to 5.0), vitamin A and D (HR = 4.6, 95% CI 4.3 to 4.9), and loop diuretics, for example furosemide (HR = 3.7; 95% CI 3.6 to 3.8). Thiazide diuretics, however, were only weakly associated with a mortality risk (HR = 1.5; 95% CI 1.4 to 1.5). Surprisingly, only weak associations with mortality were seen for major cardiovascular drug classes.CONCLUSIONS: A majority of older men had a history of prescribed medications and many drug classes were associated with mortality rate, including drug classes not directly indicated for a specific comorbidity represented in commonly used comorbidity measures. Prescription history can improve baseline risk assessment but some associations might be context-sensitive.
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Garmo, HansUppsala universitet,Urologkirurgi,Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, Guy’s Hospital, London, United Kingdom; Regional Cancer Center Uppsala Örebro, Uppsala University Hospital, Uppsala, Sweden(Swepub:uu)hga27600
(författare)
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Robinson, David
(författare)
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Stattin, PärUppsala universitet,Urologkirurgi(Swepub:uu)parst892
(författare)
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Uppsala universitetAnestesiologi och intensivvård
(creator_code:org_t)
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Ingår i:PLOS ONE: Public Library of Science (PLoS)15:101932-6203
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