Adverse drug reactions in hospital in-patients: a prospective analysis of 3695 patient-episodes.
Adverse drug reactions in hospital in-patients: a prospective analysis of 3695 patient-episodes.
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DOI：
10.1371/journal.pone.0004439
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发表时间：
2009
期刊：
影响因子：
3.7
通讯作者：
Pirmohamed M
中科院分区：
文献类型：
--
作者：
Davies EC;Green CF;Taylor S;Williamson PR;Mottram DR;Pirmohamed M
药物不良反应 (ADR) 是导致入院的主要原因，但目前缺乏有关入院后发生的 ADR 发生率和临床特征的最新数据。 2005 年六个月内入住 12 个病房的患者在入院期间接受了 ADR 评估。记录并分析可疑 ADR 的因果关系、严重性和可避免性，以及是否会增加住院时间。进行多变量分析以确定 ADR 的风险因素。在评估多变量模型中包含的因素时，使用 5% 显着性水平。在评估 ADR 的 3695 例患者中，有 545 例（14.7%，95% CI 13.6–15.9%）经历了一种或多种 ADR。一半的 ADR 是肯定或可能避免的。与没有发生 ADR 的患者相比，发生 ADR 的患者更有可能年龄较大、女性、服用更多药物且住院时间更长。然而，根据对代表性患者样本的多变量分析，ADR 的唯一显着预测因素是患者服用的药物数量，每增加一种药物，ADR 发作的风险就会乘以 1.14（95% CI 1.09，1.20）。 ADR 直接增加了 147 名 (26.8%) 患者的住院时间。最常与不良反应相关的药物是利尿剂、阿片类镇痛剂和抗凝剂。总之，大约七分之一的住院患者经历过 ADR，这是发病的一个重要原因，每次入院时患者的住院时间平均增加 0.25 天。药品不良反应对医院的总体负担较高，迫切需要有效的干预策略来减轻这一负担。
Adverse drug reactions (ADRs) are a major cause of hospital admissions, but recent data on the incidence and clinical characteristics of ADRs which occur following hospital admission, are lacking. Patients admitted to twelve wards over a six-month period in 2005 were assessed for ADRs throughout their admission. Suspected ADRs were recorded and analysed for causality, severity and avoidability and whether they increased the length of stay. Multivariable analysis was undertaken to identify the risk factors for ADRs. The 5% significance level was used when assessing factors for inclusion in multivariable models. Out of the 3695 patient episodes assessed for ADRs, 545 (14.7%, 95% CI 13.6–15.9%) experienced one or more ADRs. Half of ADRs were definitely or possibly avoidable. The patients experiencing ADRs were more likely to be older, female, taking a larger number of medicines, and had a longer length of stay than those without ADRs. However, the only significant predictor of ADRs, from the multivariable analysis of a representative sample of patients, was the number of medicines taken by the patient with each additional medication multiplying the hazard of an ADR episode by 1.14 (95% CI 1.09, 1.20). ADRs directly increased length of stay in 147 (26.8%) patients. The drugs most frequently associated with ADRs were diuretics, opioid analgesics, and anticoagulants. In conclusion, approximately one in seven hospital in-patients experience an ADR, which is a significant cause of morbidity, increasing the length of stay of patients by an average of 0.25 days/patient admission episode. The overall burden of ADRs on hospitals is high, and effective intervention strategies are urgently needed to reduce this burden.
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影响因子：
105.7
作者：
HURWITZ, N;WADE, OL
通讯作者：
WADE, OL
影响因子：
168.9
作者：
Dean, B;Schachter, M;Barber, N
通讯作者：
Barber, N
DOI：
10.1111/j.1742-1241.2006.01130.x
发表时间：
2007-01-01
影响因子：
2.6
作者：
Ducharme, M. M.;Boothby, L. A.
通讯作者：
Boothby, L. A.
影响因子：
--
作者：
Howard, RL;Avery, AJ;Partridge, M
通讯作者：
Partridge, M
影响因子：
2.9
作者：
HOIGNE, R;LAWSON, DH;WEBER, E
通讯作者：
WEBER, E