Kane-Gill Sandra L, Dasta Joseph F, Schneider Philip J, Cook Charles H
Department of Pharmacy and Therapeutics, University of Pittsburgh, Pittsburgh, Pennsylvania 15101, USA.
J Trauma. 2005 Dec;59(6):1457-62. doi: 10.1097/01.ta.0000196009.42623.50.
Clinical abnormalities associated with drug therapy may lead to injury if untreated. Detection of preceding drug-related hazardous conditions (DRHCs) may provide the opportunity to prevent injury. This study evaluated the frequency of abnormal laboratory values attributed to the effect of drugs.
A total of 590 patients consecutively admitted to a surgical intensive care unit during a 3-month period were prospectively studied. Serum electrolyte, platelet, creatinine, glucose, magnesium, and liver enzyme concentrations were classified as either normal or abnormal using standard criteria. DRHCs were abnormal laboratory results determined to be caused by drugs.
DRHCs were detected in 16.4% of patients, reflecting a rate of 47 events per 1,000 patient days. 66%, 22%, and 12% of DRHCs were categorized as either definite, probable, or possible, respectively. In 97% of suspected DRHCs, clinicians responded by ordering additional laboratory tests or changing drug regimens.
Monitoring laboratory values and assessing the association to medications may reduce the risk of injury consequent to adverse drug events.
与药物治疗相关的临床异常情况若不治疗可能导致损伤。检测先前与药物相关的危险状况（DRHCs）可能提供预防损伤的机会。本研究评估了归因于药物作用的实验室异常值的发生频率。
对在3个月期间连续入住外科重症监护病房的590例患者进行前瞻性研究。使用标准标准将血清电解质、血小板、肌酐、葡萄糖、镁和肝酶浓度分类为正常或异常。DRHCs是被确定由药物引起的实验室异常结果。
在16.4%的患者中检测到DRHCs，反映出每1000个患者日有47起事件的发生率。分别有66%、22%和12%的DRHCs被归类为确定、很可能或可能。在97%的疑似DRHCs中，临床医生通过安排额外的实验室检查或改变药物治疗方案做出反应。
监测实验室值并评估与药物的关联可能降低药物不良事件导致损伤的风险。
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