Table 3.
Sequentially Adjusted Association Between PIM Exposure and Adverse Outcomes
| Outcome/Exposure | No. of Events (Event Rate) | OR (95% CI) or RR (95% CI)a | |||
|---|---|---|---|---|---|
| Unadjusted | Model 1b | Model 2c | Model 3d | ||
| Hospitalizations | |||||
| No PIM | 4,724 (57.9) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| 1 PIM | 4,711 (72.7) | 1.16 (1.08–1.24) | 1.16 (1.08–1.24) | 1.13 (1.05–1.21) | 1.09 (1.01–1.17) |
| 2 PIMs | 2,818 (88.0) | 1.32 (1.20–1.44) | 1.33 (1.21–1.46) | 1.26 (1.15–1.39) | 1.18 (1.07–1.30) |
| ≥3 PIMs | 2,045 (104.7) | 1.52 (1.35–1.71) | 1.55 (1.38–1.74) | 1.53 (1.36–1.72) | 1.35 (1.19–1.53) |
| Death | |||||
| No PIM | 135 (1.3) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| 1 PIM | 152 (1.8) | 1.42 (1.12–1.80) | 1.34 (1.06–1.69) | 1.25 (0.97–1.62) | 1.19 (0.91–1.54) |
| 2 PIMs | 113 (2.6) | 2.14 (1.66–2.76) | 1.99 (1.54–2.58) | 1.79 (1.36–2.37) | 1.62 (1.21–2.17) |
| ≥3 PIMs | 75 (3.1) | 2.32 (1.74–3.09) | 2.28 (1.70–3.05) | 1.97 (1.42–2.75) | 1.65 (1.14–2.41) |
| KRT | |||||
| No PIM | 285 (2.8) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| 1 PIM | 236 (3.1) | 1.04 (0.88–1.24) | 1.15 (0.96–1.37) | 1.29 (1.04–1.61) | 1.24 (0.99–1.56) |
| 2 PIMs | 108 (2.8) | 0.95 (0.76–1.19) | 1.12 (0.89–1.41) | 1.23 (0.93–1.64) | 1.14 (0.84–1.55) |
| ≥3 PIMs | 55 (2.5) | 0.77 (0.58–1.04) | 1.12 (0.89–1.41) | 1.38 (0.95–2.01) | 1.23 (0.82–1.85) |
| Kidney disease composite outcomee | |||||
| No PIM | 333 (3.4) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| 1 PIM | 279 (3.6) | 1.05 (0.89–1.24) | 1.14 (0.97–1.35) | 1.18 (0.98–1.43) | 1.15 (0.95–1.39) |
| 2 PIMs | 126 (3.3) | 0.95 (0.77–1.17) | 1.11 (0.89–1.37) | 1.15 (0.90–1.48) | 1.09 (0.84–1.41) |
| ≥3 PIMs | 71 (3.3) | 0.86 (0.66–1.12) | 1.01 (0.77–1.32) | 1.33 (0.96–1.83) | 1.21 (0.85–1.72) |
| Falls | |||||
| No PIM | 48 (2.6) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| 1 PIM | 58 (4.0) | 1.66 (1.10–2.50) | 1.59 (1.05–2.41) | 1.44 (0.94–2.22) | 1.35 (0.87–2.09) |
| 2 PIMs | 26 (4.5) | 1.84 (1.10–3.09) | 1.75 (1.04–2.94) | 1.46 (0.84–2.56) | 1.32 (0.74–2.35) |
| ≥3 PIMs | 30 (8.4) | 4.06 (2.40–6.85) | 3.81 (2.22–6.55) | 3.50 (2.00–6.11) | 2.85 (1.54–5.26) |
Abbreviations: KRT, initiation of kidney replacement therapy; OR, odds ratio; PIM, potentially inappropriate medication; RR, rate ratio.
a
Rate ratio for hospitalization model.
b
Model 1 adjusted for age, other demographics, and participant site.
c
Model 2 is adjusted for model 1 covariates and eGFR, body mass index, diabetes, any cardiovascular disease, hypertension, arthritis, and prior nephrology care.
d
Model 3 is adjusted for model 2 covariates and number of medications.
e
Defined as occurrence of KRT or halving of baseline estimated glomerular filtration rate.