Hospitalizations because of Adverse Drug Reactions in Elderly Patients Admitted through the Emergency Department A Prospective Survey
Hospitalizations because of Adverse Drug Reactions in Elderly Patients Admitted through the Emergency Department A Prospective Survey
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DOI：
10.2165/00002512-200926060-00004
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发表时间：
2009-01-01
期刊：
影响因子：
2.8
通讯作者：
Lapeyre-Mestre, Maryse
中科院分区：
文献类型：
--
作者：
Olivier, Pascale;Bertrand, Lionel;Lapeyre-Mestre, Maryse
背景和目标：已经进行了几项研究，以确定老年人群中药物不良反应（ADR）的频率和特征，重点关注导致住院的药物不良反应。然而，这些研究中的大多数在评估风险因素，特别是患者的肾脏状态方面的能力有限。因此，本前瞻性研究的目的是评估ADR的发病率和相关因素导致住院的老年population.Methods：所有患者年龄>= 65岁，通过急诊科在2002-3年的4个非连续的周收治到图卢兹大学医院被列入本研究中，除了在门诊护理或故意过量收治的患者。入院的患者的特征与入院的患者的其他reasons.Results：住院的ADRs的发病率为8.37每100入院（95%CI 6.52，10.52），对应于66例ADRs 789入院。与药物不良反应相关的最重要因素是服用药物的数量（比值比[OR] 1.18; 95% CI 1.08，1.29），自我用药（OR 2.34; 95% CI 1.18，4.66），使用抗血栓药物（解剖学、治疗学和化学[ATC]分类B 01; OR 2.26; 95% CI 1.33，3.88）和使用抗菌药物（ATC J 01; OR 4.04; 95% CI 1.50，10.83）。令人惊讶的是，暴露于酸相关疾病的药物与低风险的ADRs（OR 0.26; 95%CI 0.09，0.76）。结论：一个显着的发生率ADRs导致住院的老年人。我们的研究表明，有必要为公众提供更多关于自我用药引起的潜在ADR的信息，并为处方医生提供关于药物相互作用和多种药物引起的ADR的信息。
Background and objectives: Several studies have been conducted to determine the frequency and characteristics of adverse drug reactions (ADRs) in elderly populations, focusing on those leading to hospital admission. However, most of these studies have been limited in their ability to assess risk factors, particularly the renal status of patients. Thus, the aim of this prospective study was to assess the incidence of ADRs and associated factors leading to hospital admissions in the elderly population.Methods: All patients aged >= 65 years admitted to the Toulouse University Hospital through the Emergency Department during four non-consecutive weeks in 2002-3 were included in this study except for patients in ambulatory care or admitted for intentional overdoses. The characteristics of patients admitted for a suspected ADR were compared with those of patients admitted for other reasons.Results: The incidence of hospital admissions for ADRs was 8.37 per 100 admissions (95% CI 6.52, 10.52), corresponding to 66 patients with ADRs among 789 admissions. The most important factors associated with ADRs were the number of drugs being taken (odds ratio [OR] 1.18; 95% CI 1.08, 1.29), self-medication (OR 2.34; 95% CI 1.18, 4.66), use of antithrombotics (Anatomic Therapeutic and Chemical [ATC] classification B01; OR 2.26; 95% CI 1.33, 3.88) and use of antibacterial drugs (ATC J01; OR 4.04; 95% CI 1.50, 10.83). Surprisingly, exposure to drugs for acid-related disorders was associated with a low risk of ADRs (OR 0.26; 95% CI 0.09, 0.76).Conclusion: A significant incidence of ADRs leading to hospital admissions was found among elderly people. Our study showed that there is a need to increase the availability of information for the general public concerning potential ADRs due to self-medication and for prescribers concerning ADRs due to drug-drug interactions and polypharmacy.