Huet E, Closon A, Lebel D, Durand C, Bussières J-F
Département de pharmacie, centre hospitalier universitaire Sainte-Justine, 3175, chemin de la Côte-Sainte-Catherine, H3T 1C5 Montréal (Québec), Canada.
Ann Pharm Fr. 2011 Nov;69(6):317-23. doi: 10.1016/j.pharma.2011.08.003. Epub 2011 Oct 27.
The main objective is to describe the incidence of adverse drug reactions (ADR) coded by medical archivists from patient medical records. The secondary objective is to determine the drug classes causing ADRs according to age and to compare the incidence according to the revision of the International Classification of Diseases (ICD) used.
This is a non experimental and descriptive study of ADR in a teaching hospital. All ADR codes (i.e. codes E930 to E949 in ICD-9 version and codes Y40 to Y59 in ICD-10 version) in medical records of patients aged 18 and under have been included. The research protocol has been accepted by the institutional review board committee of CHU Sainte-Justine.
We calculated on average 225.7±65.1 ADRs coded per year for an annual average incidence of pediatric ADRs of 1.64%±0.41% (n=4740 ADRs, average 1.3 ADR per patient) for a total of 294,480 admissions between April 1st, 1989 and March 31st, 2010. ADRs coded occurred amongst 0 to 2 years old and 12 to18 years old in a proportion of 30.5% and amongst 3 to 11 years old in a proportion of 39%. ADRs are caused by antibiotics (28%), anticancer drugs (18%), opiates (6%) and steroids (6%) which represent around 50% of all ADRs.
The incidence of pediatric ADRs is increasing throughout the studied period, mainly because a more complete codification of episodes of care by medical archivists has been prioritized by the hospital administration.
主要目的是描述医学档案管理员根据患者病历编码的药物不良反应（ADR）发生率。次要目的是根据年龄确定导致ADR的药物类别，并比较根据所使用的国际疾病分类（ICD）修订版得出的发生率。
这是一项针对教学医院中ADR的非实验性描述性研究。纳入了18岁及以下患者病历中的所有ADR编码（即ICD - 9版本中的E930至E949编码以及ICD - 10版本中的Y40至Y59编码）。该研究方案已获得圣贾斯汀大学医疗中心机构审查委员会的批准。
在1989年4月1日至2010年3月31日期间的294,480例入院病例中，我们计算出每年平均编码225.7±65.1例ADR，儿科ADR的年平均发生率为1.64%±0.41%（n = 4740例ADR，平均每位患者1.3例ADR）。编码的ADR在0至2岁和12至18岁患者中的发生率为30.5%，在3至11岁患者中的发生率为39%。ADR由抗生素（28%）、抗癌药物（18%）、阿片类药物（6%）和类固醇（6%）引起，这些药物导致的ADR约占所有ADR的50%。
在整个研究期间，儿科ADR的发生率在上升，主要原因是医院管理部门优先对医学档案管理员对护理事件进行更完整的编码。
