Table 2.
Unadjusted and fully adjusted associations between patient characteristics and PPI initiation
| Unadjusted OR | 95% CI | Adjusted OR | 95% CI | |
|---|---|---|---|---|
| Age in yrs (continuous) | 0.99 (per yr increase) | 0.99–1.00 | 1.00 | 1.00–1.01 |
| Gender (female) | 0.73** | 0.65–0.83 | 1.00 | 0.86–1.15 |
| Geographic region Midwest† Northeast Southeast West |
-- 1.21 1.08 1.26** |
-- 0.99–1.47 0.88–1.32 1.07–1.49 |
-- 1.43** 0.99 1.31** |
-- 1.11–1.83 0.79–1.24 1.08–1.57 |
| Corticosteroid dose category (mg) 0–<5† 5–<10 10–<20 20–<30 30–<40 40–<50 50–<60 60–<70 70–<79 ≥80 |
-- 0.62** 0.82 1.21 1.39* 1.54** 4.20** 3.17** 4.72** 3.68** |
-- 0.48–0.79 0.66–1.00 0.96–1.53 1.05–1.83 1.20–1.99 2.91–6.05 2.50–4.02 2.27–9.82 2.67–5.08 |
-- 0.77 0.92 0.97 1.08 1.34 3.53** 2.05** 2.85* 2.13** |
-- 0.57–1.03 0.71–1.19 0.73–1.30 0.77–1.51 0.98–1.82 2.31–5.40 1.52–2.76 1.26–6.47 1.45–3.12 |
| Number of co–morbid conditions‡ | 1.44** | 1.38–1.51 | 1.21** | 1.13–1.28 |
| Rheumatoid arthritis | 0.51** | 0.42–0.61 | 0.82 | 0.66–1.01 |
| Asthma/Chronic obstructive pulmonary disease | 1.40** | 1.16–1.68 | 0.91 | 0.74–1.13 |
| Cough | 1.28* | 1.06–1.56 | 0.89 | 0.71–1.11 |
| Congestive heart failure | 2.99** | 2.51–3.57 | 1.25 | 0.99–1.57 |
| Obesity | 1.81** | 1.26–2.61 | 1.14 | 0.76–1.71 |
| Tobacco use | 1.81** | 1.37–2.39 | 1.15 | 0.84–1.56 |
| Alcohol abuse | 2.77** | 1.63–4.71 | 1.08 | 0.59–1.57 |
| Dementia | 1.32 | 0.80–2.19 | 0.80 | 0.46–1.39 |
| Gait imbalance or a history of falls | 1.81** | 1.26–2.59 | 0.96 | 0.63–1.45 |
| Coronary artery disease | 1.99** | 1.69–2.34 | 1.21 | 0.97–1.50 |
| Cerebrovascular disease | 2.01** | 1.63–2.49 | 1.11 | 0.86–1.43 |
| Peripheral vascular disease | 1.51* | 1.06–2.15 | 0.86 | 0.58–1.28 |
| Intestinal malabsorption | 2.71** | 1.44–5.08 | 1.05 | 0.52–2.13 |
| Chronic renal insufficiency | 4.55** | 3.94–5.23 | 2.06** | 1.73–2.46 |
| Endocrine disorders affecting bone metabolism | 1.73** | 1.32–2.26 | 0.89 | 0.66–1.20 |
| Disorders resulting in immunodeficiency | 2.31** | 1.37–3.89 | 1.27 | 0.71–2.26 |
| Inflammatory bowel disease | 1.03 | 0.80–1.31 | 0.88 | 0.67–1.16 |
| Osteoporosis | 1.06 | 0.83–1.36 | 1.25 | 0.94–1.66 |
| History of seizures or syncope | 1.94** | 1.52–2.49 | 0.95 | 0.72–1.26 |
| Chronic liver disease | 3.21** | 2.64–3.91 | 1.82** | 1.45–2.28 |
| Nursing home admission in the past 12 months | 2.75** | 2.18–3.45 | 1.24 | 0.93–1.64 |
| Diabetes | 1.60** | 1.36–1.88 | 1.10 | 0.90–1.33 |
| Hospitalization in the past 30 days | 7.94** | 6.96–9.06 | 4.71** | 4.02–5.52 |
| History of GERD or peptic ulcer disease | 1.97** | 1.63–2.38 | 1.54** | 1.24–1.91 |
| Visits with a physician in the past year | 1.01 | 1.00–1.01 | 1.00 | 0.99–1.01 |
| Number of medications prescribed in the past year | 1.02** | 1.01–1.04 | 1.00 | 0.98–1.01 |
| Use of anticoagulation | 1.91** | 1.48–2.48 | 1.24 | 0.92–1.67 |
| Use of anti–platelet medication | 1.03 | 0.66–1.60 | 0.57* | 0.35–0.93 |
| Use of NSAIDs in prior 90 days | 0.53** | 0.43–0.66 | 0.82 | 0.64–1.03 |
| Concurrent use of NSAIDs | 0.81 | 0.59–1.12 | 1.89** | 1.32–2.70 |
| Prior use of H2RA | 1.30 | 0.91–1.85 | 1.00 | 0.67–1.47 |
| Use of immunosuppressive medications | 0.37** | 0.28–0.48 | 0.61** | 0.46–0.83 |
| Use of thyroid replacement hormone | 0.84 | 0.68–1.04 | 0.86 | 0.67–1.09 |
| Use of cardiovascular medications | 1.33** | 1.17–1.52 | 0.90 | 0.76–1.07 |
| Use of bisphosphonates or vitamin D supplements | 0.63** | 0.50–0.80 | 0.85 | 0.65–1.11 |
*
p-value <0.05
**
p-value <0.01
†
reference group
‡
Analyzed in separate model adjusted for age, gender, region, hospitalization, nursing home residency, frequency of physician visits, number of drugs prescribed in the past year, corticosteroid dose, and the use of the following medications: anticoagulants, anti-platelet agents, NSAIDs (prior and concurrent use separately), drugs to prevent bone loss, cardiovascular drugs, H2 receptor antagonists, thyroid hormone, and immunosuppressants other than corticosteroids.