Safety events in kidney transplant recipients: results from the folic Acid for vascular outcome reduction in transplant trial.
Safety events in kidney transplant recipients: results from the folic Acid for vascular outcome reduction in transplant trial.
复制标题
肾移植受者的安全事件：移植试验中叶酸减少血管结局的结果。
DOI：
10.1097/tp.0000000000000454
复制
发表时间：
2015
期刊：
影响因子：
6.2
通讯作者：
FAVORITStudyInvestigators
中科院分区：
文献类型：
--
作者：
Weir,MatthewR;Gravens-Muller,Lisa;Costa,Nadiesda;Ivanova,Anastasia;Manitpisitkul,Wana;Bostom,AndrewG;Diamantidis,ClarissaJ;FAVORITStudyInvestigators
BackgroundKidney transplant recipients are at increased risk for adverse safety events related to their reduced renal function and many medications.MethodsWe determined the incidence of adverse safety events based on previously defined Agency for Healthcare and Research Quality（AHRQ）International Classification of Diseases-9（ICD-9）code derived patient safety indicators（PSI）叶酸降低血管预后移植试验参与者中，这些参与者住院治疗，按估计肾小球滤过率（GFR）的三分位数分层。我们还检查了Micromedex定义的两种预防性药物-药物相互作用的频率，以及两种药物的使用可能是禁忌的，因为在基线时和每年在4，110名参与者中，叶酸减少移植试验药物词库中的血管结局GFR降低。Logistic回归用于检查患者安全性事件与基线人口统计学和临床变量之间的关系。事件发生率估计在参与者和访问level.ResultsOf的2,514例住院治疗，978（38.9%）经历了AHRQ PSI。与更常见的AHRQ PSI相关的因素包括：US位置、心血管疾病或糖尿病史和估计GFR的三分位数。在参与者一级，4 110名参与者中有2 524人（61.4%）正在服用钙调磷酸酶抑制剂和他汀类药物，378（9.2%）正在服用硫唑嘌呤和血管紧张素转换酶抑制剂，171（12.9%）正在服用磺脲类药物），45（3.4%）尽管基线GFR低于40 mL/min/1.73 m2，但仍服用二甲双胍。结论我们得出结论，移植接受者需要仔细监测，以防止不良后果。
BackgroundKidney transplant recipients are at increased risk for adverse safety events related to their reduced renal function and many medications.MethodsWe determined the incidence of adverse safety events based on previously defined Agency for Healthcare and Research Quality (AHRQ) International Classification of Diseases-9 (ICD-9) code-derived patient safety indicators (PSI) in the Folic Acid for Vascular Outcome Reduction in Transplant trial participants who had a hospitalization stratified by tertiles of estimated glomerular filtration rate (GFR). We also examined the frequency of Micromedex defined two precautionary drug-drug interactions, and two medications whose use may be contraindicated because of reduced GFR from the Folic Acid for Vascular Outcome Reduction in Transplant trial medication thesaurus at baseline, and annually among 4,110 participants. Logistic regression was used to examine the relationship between patient safety events and baseline demographic and clinical variables at a participant level. Event rates were estimated at participant and visit levels.ResultsOf the 2,514 patients with a hospitalization, 978 (38.9%) experienced an AHRQ PSI. Factors which were associated with more common AHRQ PSI included: US location, history of cardiovascular disease or diabetes, and lower tertile of estimated GFR. At a participant level, 2,524 of the 4,110 participants (61.4%) were taking calcineurin inhibitor and statin, 378 (9.2%) were taking azathioprine and an angiotensin-converting enzyme inhibitor, 171 (12.9%) were taking a sulfonylurea), 45 (3.4%) were taking metformin despite a baseline GFR below 40 mL per min per 1.73 m 2.ConclusionWe conclude that patient safety events are not uncommon in kidney transplant recipients. Careful monitoring is necessary to prevent adverse outcomes.