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药物不良反应:一项针对某大学医院内科病房的队列研究。

Adverse drug reactions: a cohort study in internal medicine units at a university hospital.

作者信息

Camargo Aline Lins, Cardoso Ferreira Maria Beatriz, Heineck Isabela

机构信息

Medical Sciences-UFRGS, CIM-RS-Centro de Informações sobre Medicamentos do Rio Grande do Sul, Porto Alegre, RS, Brazil.

出版信息

Eur J Clin Pharmacol. 2006 Feb;62(2):143-9. doi: 10.1007/s00228-005-0086-7. Epub 2006 Jan 5.

Abstract

OBJECTIVES

Adverse drug reactions (ADRs) are important causes of hospitalization, morbidity and mortality in hospitalized patients. In addition to the impact they have on human life, they also significantly influence health costs. This study intended to (1) identify suspected ADRs and establish their frequency of development, (2) establish a causal relationship with the suspected drug(s) and (3) verify if there is an association between the development of an ADR and factors such as age, gender, number of diagnoses and number of prescribed medications.

METHODS

This cohort study considered hospitalized patients at five inpatient internal medicine units in a university hospital located in southern Brazil. Patients were intensively monitored in order to identify suspected ADRs during hospitalization. The types of reactions were classified and a causal relationship was established using an algorithm.

RESULTS

The cohort study followed 333 patients and approximately 43% of them presented at least one suspected ADR. Three hundred and sixty suspected ADRs were identified, with 19.7% manifesting before the patient was admitted and 80.3% during hospitalization. Medications that were most commonly involved in these suspected cases were anti-infectious agents followed by drugs that act on the central nervous system (CNS). The follow-up length and number of medications in use were independent risk factors for the development of an ADR. The same relationship was not observed for age, gender and number of diagnoses.

CONCLUSION

ADRs are a major problem in our setting and measures must be adopted to minimize them.

摘要

目的

药物不良反应(ADR)是住院患者住院、发病和死亡的重要原因。除了对人类生命产生影响外,它们还对医疗成本有重大影响。本研究旨在(1)识别疑似ADR并确定其发生频率,(2)确定与疑似药物的因果关系,以及(3)验证ADR的发生与年龄、性别、诊断数量和处方药物数量等因素之间是否存在关联。

方法

本队列研究纳入了巴西南部一家大学医院五个内科住院病房的住院患者。对患者进行密切监测,以识别住院期间的疑似ADR。对反应类型进行分类,并使用一种算法确定因果关系。

结果

该队列研究跟踪了333名患者,其中约43%的患者出现了至少一种疑似ADR。共识别出360例疑似ADR,其中19.7%在患者入院前出现,80.3%在住院期间出现。这些疑似病例中最常涉及的药物是抗感染药物,其次是作用于中枢神经系统(CNS)的药物。随访时间和使用的药物数量是ADR发生的独立危险因素。年龄、性别和诊断数量未观察到相同的关系。

结论

在我们的研究环境中,ADR是一个主要问题,必须采取措施将其降至最低。

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