Polypharmacy, determinants, and adverse outcomes in elderly patients with heart failure: a multicenter retrospective cohort study of 7,361 subjects

作者：Wei Zhong, Feng Jiang, Haibin Wang, Xuan Yin, Bowen Zhang, Hanbin Cui, Jifang Zhou · 发表于：BMC Geriatrics · 年份：2026 · DOI：10.1186/s12877-025-06948-9 · 被引用次数：2 · 研究领域：Medicine

Elderly patients with heart failure (HF) often present with multiple comorbidities and complex medication regimens. However, research on polypharmacy and potentially inappropriate medication (PIM) in Asian population with HF remains limited. The research studied elderly patients with HF (≥ 65 years) from the Ningbo Yinzhou District medical database from 2011 to 2022. The cohort categorized them into four groups based on the number of drug types recorded during the 90-day period following their diagnosis: non polypharmacy (0–4 drugs), polypharmacy (5–9 drugs), hyperpolypharmacy (10–14 drugs), and super hyperpolypharmacy (≥ 15 drugs). PIM was identified based on the 2019 Beers Criteria from inpatient and outpatient records. Dose-dependent PIM criteria were excluded due to the lack of dosage information. The primary outcome was a composite of cardiovascular death or HF hospitalization, while secondary outcomes included worsening chronic heart failure (WCHF), all-cause mortality, and hospitalizations. In 7,361 elderly patients with HF, 82.3% were prescribed five or more medications, and 53.2% had PIM. Female sex and hyperlipidemia were negatively associated with polypharmacy, whereas diabetes, chronic obstructive pulmonary disease, coronary artery disease, and healthcare utilization were positive predictors. Polypharmacy emerged as the strongest determinant of PIM, increasing the risk by 152%. With increasing medication burden, risks for the primary outcome, WCHF, and mortality e...