Hospital admissions due to adverse drug reactions in the elderly. A meta-analysis
Hospital admissions due to adverse drug reactions in the elderly. A meta-analysis
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DOI：
10.1007/s00228-017-2225-3
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发表时间：
2017-06-01
影响因子：
2.9
通讯作者：
Carvajal, Alfonso
中科院分区：
文献类型：
--
作者：
Oscanoa, T. J.;Lizaraso, F.;Carvajal, Alfonso
前言目前公认的药物不良反应(ADRs)是疾病的一大负担。特别令人担忧的是由ADR引起的住院，特别是老年人；他们接受的药物最多，最容易出现ADR。因此，我们的目标是开展一项以老年人群为重点的不良反应住院研究。方法对60岁以上患者不良反应住院研究进行系统回顾和荟萃分析。在主要数据库中对这些文献进行了计算机检索。搜寻工作从1988年持续到2015年。结果最终入选文献42篇，全部发表于1988年1月至2015年8月。住院总平均百分比为8.7%(95%可信区间，7.6-9.8%)。非甾体抗炎药是与这些入院更频繁相关的药物类别之一(百分比从2.3%到33.3%不等)。在9项研究中，不适当的用药作为危险因素进行了研究，其中4项研究发现，这些药物与入院时间之间存在统计学意义上的关系。结论大约十分之一的老年患者住院是由于ADRs。疾病的巨大负担是由于少数可识别的药物类别；在大多数情况下，反应是众所周知的，而且很可能是可以预防的。卫生当局需要有目的感和决心来面对这一问题。医生在给这些患者开一些特定的可识别的药物时，应该意识到这一点。
Introduction It is currently admitted that adverse drug reactions (ADRs) account for a great burden of disease. Of particular concern are ADR-induced hospital admissions, particularly in the elderly; they receive most of the medications and they are the most prone to develop ADRs. Therefore, our aim was to carry out a study of ADR-induced hospital admissions focused on the elderly population.Method For the purpose, a systematic review and meta-analysis was performed of those studies addressing ADR-induced hospital admissions in patients over 60 years of age. A computerized search of the literature was carried out in the main databases. The search spans from 1988 to 2015. A pooled prevalence figure was calculated with 95% CIs; heterogeneity was also explored.Result The final number of selected articles was 42; all of them were published between January 1988 and August 2015. The overall average percentage of hospital admissions was 8.7% (95% CI, 7.6-9.8%). NSAIDs are one of the medication classes more frequently related to these admissions (percentages range from 2.3 to 33.3%). Inappropriate medication as a risk factor was studied in nine studies, four found a statistically significant relationship between those medications and hospital admissions.Conclusions Circa one in ten hospital admissions of older patients are due to ADRs. A great burden of disease is due to a few and identifiable medication classes; in most of the cases, the reactions are well known and probably preventable. A sense of purpose and determination is needed by health authorities to face this problem. Doctors, on their part, should be aware when prescribing some specific identifiable medications to these patients.