Risk factors for adverse drug events in hospitalized elderly patients: A geriatric score

ObjectiveTo propose a score to evaluate the risk of ADEs in hospitalized elderly patients.DesignThis score was developed on the basis of the IMEPAG study.SettingIn France, in the greater Paris area in 16 geriatric rehabilitation centres.ParticipantsAll individuals aged 65 years or older who experienced an ADE during the 4 weeks of the study period.MeasurementsADEs were detected using a standardized checklist. Separate multivariable models were constructed using any occurrence of an ADE as the outcome with stepwise logistic regression. Significant variables were included to compute the ADE risk score. The score was validated by resampling technique (bootstrap).ResultsDuring the study, on 526 hospitalized patients, 152 had at least one ADE (mean age 83.6 ± 7.9 years). Risk factors included in the final score were: number of medications (if ≥ 7), the presence of antipsychotic treatment and recent anticoagulant. The number of drugs taken was the strongest predictor of ADEs. The final score was between zero and 34, with an ADE risk of 12% for a score ≤ 6, 28% for a score of 7–12, 35% for a score of 13–18 and 52% for a score > 18. The area under the ROC curve was 0.70 (95% CI, 0.65–0.74).ConclusionWe have developed and validated a simple and practical score to detect the risk of ADEs in elderly hospitalized patients. We have also proposed a classification of risk of the drugs most frequently associated with ADEs.