Department of Critical Care Medicine, Antwerp University Hospital, University of Antwerp, Edegem, Belgium.
Am J Crit Care. 2011 Nov;20(6):e131-40. doi: 10.4037/ajcc2011818.
Adverse drug events are considered determinants of patient safety and quality of care.
To assess the characteristics of adverse drug events in patients admitted to an intensive care unit and determine the impact of severity of illness and nursing workload on the prevalence of the events.
A cross-sectional survey based on retrospective analysis of a high-quality patient data management system for a university-based intensive care unit was used. The prevalence of adverse drug events was measured by using a validated global trigger tool adapted for the critical care environment. Severity was determined by using a validated algorithm. Disease severity and nursing workload were assessed by using validated scoring systems. An investigator blinded to the study and a panel of experts assessed putative serious adverse drug events for each drug taken. Characteristics of patients with and without adverse drug events were compared by using univariate and stepwise multivariate logistic regression.
During 175 of 1009 intensive care unit days screened, 230 adverse drug events occurred in 79 patients. The most common events were hypoglycemia, prolonged activated partial thromboplastin time, and hypokalemia. Of the adverse events, 96% were classified as causing temporary harm and 4% as causing complications. Both mean severity of disease and nursing workload were significantly higher on days when 1 or more adverse drug events occurred.
Adverse drug events were common in intensive care unit patients and were associated with illness severity and nursing workload.
不良药物事件被认为是患者安全和医疗质量的决定因素。
评估重症监护病房患者不良药物事件的特征，并确定疾病严重程度和护理工作量对事件发生率的影响。
采用基于回顾性分析的大学重症监护病房高质量患者数据管理系统的横断面调查。使用经过验证的适用于重症监护环境的全球触发工具来衡量不良药物事件的发生率。严重程度通过经过验证的算法确定。使用经过验证的评分系统评估疾病严重程度和护理工作量。一位对研究不知情的调查员和一个专家小组对每位患者使用的药物进行潜在严重不良药物事件的评估。通过单变量和逐步多变量逻辑回归比较有和无不良药物事件患者的特征。
在筛选的 1009 个重症监护病房日中的 175 天中，79 名患者发生了 230 起不良药物事件。最常见的事件是低血糖、延长的部分激活凝血酶时间和低钾血症。不良事件中，96%被归类为造成暂时伤害，4%造成并发症。发生 1 次或更多不良药物事件的日子里，疾病严重程度和护理工作量的平均值均显著升高。
重症监护病房患者中不良药物事件很常见，与疾病严重程度和护理工作量有关。
