Carbonin P, Pahor M, Bernabei R, Sgadari A
Gruppo Italiano di Farmacovigilanza nell'Anziano (G.I.F.A.), Società Italiana di Gerontologia e Geriatria, Roma, Italy.
J Am Geriatr Soc. 1991 Nov;39(11):1093-9. doi: 10.1111/j.1532-5415.1991.tb02875.x.
To study the incidence and the risk factors of adverse drug reactions.
Multicenter survey.
Hospitalized care: 22 internal medicine and 19 geriatric wards.
All patients (n = 9,148) consecutively admitted during two observation periods of 2 months.
Incidence of adverse drug reactions.
The mean age was 67.1 +/- 0.17 years (median 72); the mean duration of hospital stay was 18.1 +/- 0.19 days (median 14). Each patient was administered 5.1 +/- 0.03 (median 5) drug prescriptions. The incidence of probable or definite adverse drug reactions was 5.8% (532/9,148). In univariate analysis, the incidence of adverse drug reactions increased from 3.3% at under age 50 to 6.5% at age 70-79 and decreased over age 80 (5.8%). In multivariate logistic regression, taking more than four drugs (OR = 2.94, CI = 2.38-3.62), staying in hospital more than 14 days (OR = 2.82, CI = 2.26-3.52), having more than 4 active medical problems (OR = 1.78, CI = 1.29-2.45), staying in a medical ward instead of geriatric ward (OR = 1.33, CI = 1.09-1.63), and drinking alcohol (OR = 1.28, CI = 1.03-1.58) were positively correlated with adverse drug reactions occurrence (P less than 0.05). Age, gender, and smoking cigarettes were not significant predictors of adverse drug reactions.
Age is not an independent risk factor of adverse drug reactions, and good geriatric care can reduce the incidence of adverse drug reactions.
研究药物不良反应的发生率及危险因素。
多中心调查。
住院护理：22个内科病房和19个老年病房。
在两个为期2个月的观察期内连续收治的所有患者（n = 9148）。
药物不良反应的发生率。
平均年龄为67.1±0.17岁（中位数72岁）；平均住院时间为18.1±0.19天（中位数14天）。每位患者接受5.1±0.03（中位数5）种药物处方。可能或确定的药物不良反应发生率为5.8%（532/9148）。单因素分析中，药物不良反应发生率从50岁以下的3.3%增至70 - 79岁的6.5%，80岁以上有所下降（5.8%）。多因素逻辑回归分析显示，服用超过4种药物（比值比[OR]=2.94，可信区间[CI]=2.38 - 3.62）、住院超过14天（OR = 2.82，CI = 2.26 - 3.52）、有超过4种活动性医疗问题（OR = 1.78，CI = 1.29 - 2.45）、住在内科病房而非老年病房（OR = 1.33，CI = 1.09 - 1.63）以及饮酒（OR = 1.28，CI = 1.03 - 1.58）与药物不良反应发生呈正相关（P<0.05）。年龄、性别和吸烟并非药物不良反应的显著预测因素。
年龄不是药物不良反应的独立危险因素，良好的老年护理可降低药物不良反应的发生率。
