Drug-Drug Interactions Associated with Length of Stay and Cost of Hospitalization
Drug-Drug Interactions Associated with Length of Stay and Cost of Hospitalization
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DOI：
10.18433/j35c7z
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发表时间：
2009-01-01
影响因子：
2.7
通讯作者：
Belo, Najara
中科院分区：
文献类型：
--
作者：
Moura, Cristiano;Acurcio, Francisco;Belo, Najara
评价住院患者中药物相互作用（DDI）的发生率，并确定相关风险因素。方法对巴西一家公立医院的处方数据和病历进行回顾性横断面分析，以识别潜在的DDI。采用标准药物相互作用源识别和分类不适当的药物组合。初步诊断采用Charlson综合指数（CCI）进行分类。性别、年龄、多药治疗和住院时间等变量与潜在DDI的频率相关。结果共纳入589例患者，3,585张处方。37%的患者在住院期间暴露于至少一种潜在的相互作用。最常见的相互作用对是地高辛+呋塞米（11%）。在单因素分析中，多个变量与DDI相关，包括性别、年龄、处方药数量、住院时间和费用以及CCI。多变量分析表明，在多种药物治疗的患者中，被处方潜在DDI的调整后几率几乎是服用少于5种药物的患者的5倍。此外，住院时间、CCI和住院费用与DDI独立相关。结论处方数据分析发现，确定了大量潜在DDI。本研究结果表明，DDI与处方药物数量、住院时间和费用增加相关，这表明DDI是一个重要的临床和经济问题。可以避免对患者的潜在伤害。
To evaluate the prevalence of drug-drug interactions (DDI) in hospitalized patients and to identify associated risk factors. Methods A retrospective cross-sectional analysis of prescription data and medical records from a public hospital in Brazil was conducted to identify potential DDI. Inappropriate drug combinations were identified and classified with a standard drug interaction source. Primary diagnoses were classified with Charlson Comorbidity Index (CCI). Sex, age, polypharmacy and length of stay, among other variables, were correlated with the frequency of potential DDI. Results The study included 589 patients and 3,585 prescriptions. Thirty-seven percent of the patients were exposed to at least one potential interaction during their stay in the hospital. The most frequent interacting pair was Digoxin+Furosemide (11%). In univariate analysis, several variables were associated with DDI, including sex, age, number of prescribed drugs, length and cost of hospitalization and CCI. Multivariate analysis showed that the adjusted odds of being prescribed a potential DDI among patients in polypharmacy was almost five-fold that of patients taking fewer than five drugs. Further, length of stay, CCI and cost of hospitalization were independently associated with DDI. Conclusion Analysis of prescription data found that a substantial number of potential DDI were identified. Results of this study indicate that DDI is associated with number of prescribed drugs, increased duration of stay in the hospital and cost, which suggests that DDI are a significant clinical and economic problem. Potential harm to patients could be avoided.