Adverse Safety Events in Chronic Kidney Disease: The Frequency of "Multiple Hits"
Adverse Safety Events in Chronic Kidney Disease: The Frequency of "Multiple Hits"
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DOI：
10.2215/cjn.06210909
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发表时间：
2010-01-01
影响因子：
9.8
通讯作者：
Fink, Jeffrey C.
中科院分区：
文献类型：
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作者：
Chapin, Erica;Zhan, Min;Fink, Jeffrey C.
背景和目的：慢性肾脏疾病（CKD）缺乏标准化的患者安全指标（PSIs）；然而，未被发现的安全性事件很可能导致这种疾病的不良结局。本研究旨在确定因不同原因经历多种潜在危险事件的CKD患者的比例，并确定发生“多重撞击”的危险因素。设计、设置、参与者和测量：在退伍军人健康管理局（VHA）中回顾性检查CKD患者样本（n = 70154），从一组先验定义的指标中检查一个或多个安全事件的发生，包括医疗保健研究和质量机构（AHRQ） PSIs、低血糖、高钾血症和不考虑CKD的选定药物的剂量。结果：大约一半的队列参与者经历了一到两个不良安全事件，而7%的参与者经历了三到四个（多重）不同的事件。具有3或4个预先指定的安全事件的个体更有可能是糖尿病，非白种人，估计GFR (eGFR) < 30 ml/min/1.73 m(2)，并且
Background and objectives: Chronic kidney disease (CKD) lacks standardized patient safety indicators (PSIs); however, undetected safety events are likely to contribute to adverse outcomes in this disease. This study sought to determine the proportion of CKD patients who experience multiple potentially hazardous events from varied causes and to identify risk factors for the occurrence of "multiple hits."Design, setting, participants, & measurements: A sample of patients with CKD (n = 70,154) in the Veterans Health Administration (VHA) were retrospectively examined for the occurrence of one or more safety events from a set of indicators defined a priori, including Agency for Healthcare Research and Quality (AHRQ) PSIs, hypoglycemia, hyperkalemia, and dosing for selected medications not accounting for CKD.Results: Approximately half of the cohort participants experienced one or two adverse safety events, whereas 7% had three or four (multiple) distinct events. Individuals with three or four of the predesignated safety events were more likely to be diabetic, non-Caucasian, have an estimated GFR (eGFR) < 30 ml/min/1.73 m(2), and be