Alexopoulou Alexandra, Dourakis Spyros P, Mantzoukis Demosthenes, Pitsariotis Thomas, Kandyli Anna, Deutsch Melanie, Archimandritis Athanasios J
2nd Department of Medicine, Athens Medical School, Hippokration General Hospital, Athens, Greece.
Eur J Intern Med. 2008 Nov;19(7):505-10. doi: 10.1016/j.ejim.2007.06.030. Epub 2008 Mar 11.
Adverse drug reactions (ADRs) are a significant cause of morbidity and mortality.
A prospective study was conducted over a 6-month period. All patients consecutively admitted were enrolled in the study. Analysis included: (1) an evaluation of the frequency of ADR-related hospital admissions and their causality, severity, and preventability; (2) a description of the type of drugs involved; (3) a report of the most common clinical manifestations related to these ADRs; and (4) an assessment of the factors that were predictive of ADRs.
Seventy of the 548 admissions (12.8%) were related to an ADR. Hemorrhage represented the most common ADR (37.3%), followed by metabolic and renal events (10.8% each). The drugs most often involved were non-steroid anti-inflammatory drugs (NSAIDs), followed by diuretics, aspirin, oral anticoagulants, and oral hypoglycemic agents. A comparison between ADR and non-ADR-related admissions showed that mean number of medications and age were significantly higher for patients admitted for an ADR than for those who were not. Gender, chronic disease at admission, days of hospitalization, cognitive impairment, renal insufficiency, physical activity impairment, and use of psychoactive drugs did not differ between the two groups. In the multivariate analysis, number of drugs was the only independent predictor of ADR-related hospital admission (OR=1.064, 95% CI 1.019-1.109). In 13 of 70 (18.6%) ADR-related hospital admissions, ADRs were coded as severe.
ADRs are common causes of hospital admissions and may have important consequences. The most important determinant for ADR-related hospital admissions is the number of drugs taken.
药物不良反应（ADR）是发病和死亡的重要原因。
进行了一项为期6个月的前瞻性研究。所有连续入院的患者均纳入研究。分析内容包括：（1）评估与ADR相关的住院频率及其因果关系、严重程度和可预防性；（2）描述所涉及药物的类型；（3）报告与这些ADR相关的最常见临床表现；（4）评估ADR的预测因素。
548例入院患者中有70例（12.8%）与ADR相关。出血是最常见的ADR（37.3%），其次是代谢和肾脏事件（各占10.8%）。最常涉及的药物是非甾体抗炎药（NSAIDs），其次是利尿剂、阿司匹林、口服抗凝剂和口服降糖药。ADR相关入院患者与非ADR相关入院患者的比较显示，因ADR入院的患者平均用药数量和年龄显著高于未因ADR入院的患者。两组在性别、入院时的慢性病、住院天数、认知障碍、肾功能不全、身体活动障碍和使用精神活性药物方面无差异。在多变量分析中，药物数量是ADR相关住院的唯一独立预测因素（OR=1.064，95%CI 1.019-1.109）。在70例与ADR相关的住院病例中，有13例（18.6%）的ADR被编码为严重。
ADR是住院的常见原因，可能会产生重要后果。与ADR相关住院的最重要决定因素是用药数量。
