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伊朗一家医院重症监护病房的用药模式:一项前瞻性观察研究。

Drug-use patterns in an intensive care unit of a hospital in Iran: an observational prospective study.

作者信息

Tavallaee Mahkam, Fahimi Fanak, Kiani Shirin

机构信息

Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada.

出版信息

Int J Pharm Pract. 2010 Dec;18(6):370-6. doi: 10.1111/j.2042-7174.2010.00065.x.

Abstract

OBJECTIVES

the aim of this study was to evaluate drug-use patterns, investigate the factors influencing patient outcome, and determine the cost of drugs utilized in the intensive care unit (ICU).

METHODS

in an observational prospective study, drug prescriptions for 113 patients admitted to the ICU of a hospital in Iran were recorded. The cost of drugs in ICU and the entire hospital was also calculated. Descriptive analysis and logistic regression were used to present the results.

KEY FINDINGS

the mean age of patients was 50.3 years (SD = 20.4). The average ICU stay was 6 days. The mean length of stay was significantly lower in surgical patients compared to medical patients (odds ratio (OR) = 0.91, 95% confidence interval (CI) 0.84-0.97). Mortality rate was significantly higher among medical patients (OR = 10.5, 95% CI 3.7-29.8). There was a significant positive association between the total number of prescribed drugs or antibiotics received by patients and mortality. Patients received an average of 8.2 drugs at admission, 10.1 drugs during the first 24h and an average of 14.6 drugs over their entire stay at the icu. among drug groups, antibiotics and sedatives were most ordered drugs in icu.

CONCLUSIONS

antibiotics are responsible for the majority of ICU drug costs. Appropriate selection of antibiotics in terms of type, dose and duration of therapy could tremendously reduce the expenses in hospitals without negatively influencing the quality of healthcare.

摘要

目的

本研究旨在评估用药模式,调查影响患者预后的因素,并确定重症监护病房(ICU)使用药物的成本。

方法

在一项前瞻性观察研究中,记录了伊朗一家医院ICU收治的113例患者的药物处方。还计算了ICU和整个医院的药物成本。采用描述性分析和逻辑回归来呈现结果。

主要发现

患者的平均年龄为50.3岁(标准差=20.4)。平均ICU住院时间为6天。与内科患者相比,外科患者的平均住院时间显著更短(优势比(OR)=0.91,95%置信区间(CI)0.84 - 0.97)。内科患者的死亡率显著更高(OR = 10.5,95% CI 3.7 - 29.8)。患者接受的处方药或抗生素总数与死亡率之间存在显著正相关。患者入院时平均接受8.2种药物,前24小时接受10.1种药物,在ICU的整个住院期间平均接受14.6种药物。在药物类别中,抗生素和镇静剂是ICU中最常开具的药物。

结论

抗生素占ICU药物成本的大部分。在治疗类型、剂量和持续时间方面合理选择抗生素可以在不负面影响医疗质量的情况下大幅降低医院费用。

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