Perioperative medicine & outcomes
Preoperative prescriptions and polypharmacy in elective total hip and knee arthroplasty from 2010 to 2017, a descriptive cohort study
Authors' conclusion
Patients scheduled for elective THA and TKA used a median of 3 prescribed drugs. However, 1/3 of patients qualified as having polypharmacy and 41% used drugs requiring anesthetic consideration when planning for surgery.
Study context
- Population
- Patients undergoing elective unilateral fast-track THA and TKA, 2010–2017, Denmark
- Participants
- 32,515 patients · 36,934 procedures
- Exposure
- ≥65 years vs < 65 years
- Outcome
- Changes in the median number of prescribed drugs (ATC4-subgroups)/year
- Follow-up
- Up to 3 months preoperatively
Methodological detailsnationwide prescription registry linkage, fast-track arthroplasty database
- Nationwide prescription registry linkage
- Fast-track arthroplasty database
Main finding
As reported in the abstract
Number of prescribed drugs (ATC4-subgroups)
≥65 years
3
median · IQR 2–4
< 65 years
2
median · IQR 1–3
P < 0.001
- Median ATC4-subgroups, all patients
- 3
Observational data: associations, not effects.
Further findings
Polypharmacy (≥5 ATC4-subgroups) and severe polypharmacy (≥10)
- Polypharmacy
- 35.1%
- Severe polypharmacy
- 4.2%
- Declining trend in severe polypharmacy 2010 to 2017
- P = 0.003
Drugs of anesthetic relevance
- Any drug of anesthetic relevance
- 41.1%
- ANG-II or ACE inhibitors
- 28.0%
- Betablockers
- 15.7%
- Oral antihyperglycemics
- 7.8%
- Insulin
- 2.0%
- Vitamin-K antagonists
- 4.0%
- Direct oral anticoagulants
- 2.1%
- MAO-inhibitors/Lithium salts
- 0.3%
- ANG-II/ACE inhibitors + diuretic + NSAID ("triple whammy")
- 4.3%
Original publication
Preoperative prescriptions and polypharmacy in elective total hip and knee arthroplasty from 2010 to 2017, a descriptive cohort study. Acta Anaesthesiol Scand. Published 5 February 2023. doi:10.
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