Emergency Hospitalizations for Adverse Drug Events in Older Americans
Emergency Hospitalizations for Adverse Drug Events in Older Americans
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DOI：
10.1056/nejmsa1103053
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发表时间：
2011-11-24
影响因子：
158.5
通讯作者：
Richards, Chesley L.
中科院分区：
文献类型：
--
作者：
Budnitz, Daniel S.;Lovegrove, Maribeth C.;Richards, Chesley L.
药物不良事件是老年人住院治疗的重要可预防原因。然而，在这方面，导致这一人群住院的药物不良事件的全国代表性数据有限。方法我们使用了来自国家电子伤害监测系统-合作药物不良事件监测项目的不良事件数据（2007年至2009年）估计老年人因药物不良事件急诊就诊后住院的频率和比率，并评估具体的药物，包括那些确定为高风险或潜在的不适当的国家质量措施。根据我们的样本中确定的5077例，估计有99,628例紧急住院治疗的药物不良事件（95%置信区间[CI]，55,531至143,724），在美国。S.从2007年到2009年，每年65岁或以上的成年人。近一半的住院患者为80岁或以上的成年人（48.1%; 95% CI，44.6 - 51.6）。近三分之二的住院治疗是由于意外用药过量（65.7%; 95% CI，60.1 - 71.3）。在67.0%（95% CI，60.0 - 74.1）的住院治疗中，单独或联合使用了4种药物或药物类别：华法林（33.3%）、胰岛素（13.9%）、口服抗血小板药物（13.3%）和口服降糖药（10.7%）。高风险药物的牵连，只有1.2%（95%CI，0.7至1.7）的hospitalizations.CONCLUSIONSMost紧急住院治疗公认的药物不良事件在老年人导致一些常用的药物，和相对较少的药物通常被指定为高风险或不适当的。改善抗血栓和抗糖尿病药物的管理有可能减少老年人因药物不良事件住院的情况。
BACKGROUNDAdverse drug events are important preventable causes of hospitalization in older adults. However, nationally representative data on adverse drug events that result in hospitalization in this population have been limited.METHODSWe used adverse-event data from the National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance project (2007 through 2009) to estimate the frequency and rates of hospitalization after emergency department visits for adverse drug events in older adults and to assess the contribution of specific medications, including those identified as high-risk or potentially inappropriate by national quality measures.RESULTSOn the basis of 5077 cases identified in our sample, there were an estimated 99,628 emergency hospitalizations (95% confidence interval [CI], 55,531 to 143,724) for adverse drug events in U. S. adults 65 years of age or older each year from 2007 through 2009. Nearly half of these hospitalizations were among adults 80 years of age or older (48.1%; 95% CI, 44.6 to 51.6). Nearly two thirds of hospitalizations were due to unintentional overdoses (65.7%; 95% CI, 60.1 to 71.3). Four medications or medication classes were implicated alone or in combination in 67.0% (95% CI, 60.0 to 74.1) of hospitalizations: warfarin (33.3%), insulins (13.9%), oral antiplatelet agents (13.3%), and oral hypoglycemic agents (10.7%). High-risk medications were implicated in only 1.2% (95% CI, 0.7 to 1.7) of hospitalizations.CONCLUSIONSMost emergency hospitalizations for recognized adverse drug events in older adults resulted from a few commonly used medications, and relatively few resulted from medications typically designated as high-risk or inappropriate. Improved management of antithrombotic and antidiabetic drugs has the potential to reduce hospitalizations for adverse drug events in older adults.