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[老年患者严重药物不良反应紧急住院后的随访]

[Follow-up of elderly patients after emergency hospitalization for severe drug reactions].

作者信息

Pinchon C, Fialip J, Dumas R, Lauras H, Lavarenne J

机构信息

Centre de Pharmacovigilance, Faculté de Médecine, Clermont-Ferrand.

出版信息

Therapie. 1990 Sep-Oct;45(5):375-8.

PMID:2260028
Abstract

Forty-one observations concerning persons aged over sixty-five hospitalized for adverse drug reactions in the Emergency Service of Clermont-Ferrand University Hospital were collected and analysed by the Adverse Drug Reaction Monitoring Centre. The symptoms were predominantly haemorrhage, particularly digestive, connected with the use of oral anticoagulants, salicylates and anti-inflammatories. The follow-up of the thirty-one most severe cases (hospitalization over 48 h and/or initial resuscitation) was undertaken in hospital and other care centres. In seventeen cases, complications occurred linked to the hospitalization (especially infections and neuropsychic complications) or to the adverse reaction itself through the measures taken to correct it (particularly cardiovascular complications). The hospitalization revealed hitherto undetected conditions in twelve patients, thereby allowing the prognosis to be improved. This positive side hardly outweighs the detrimental effects of adverse drug reactions in elderly subjects (six deaths and four irreversible incapacitations). Thus vital and social prognosis of elderly appears greatly damaged by adverse drug reactions.

摘要

克莱蒙费朗大学医院急诊服务部门收集并分析了41例65岁以上因药物不良反应住院患者的观察资料,这些资料由药物不良反应监测中心负责。症状主要为出血,尤其是消化系统出血,与口服抗凝剂、水杨酸盐和抗炎药的使用有关。对31例最严重的病例(住院超过48小时和/或初始复苏)在医院和其他护理中心进行了随访。17例出现了与住院相关的并发症(尤其是感染和神经精神并发症),或因纠正不良反应所采取的措施而引发的并发症(特别是心血管并发症)。住院检查发现12例患者存在此前未被发现的病症,从而改善了预后。然而,这一积极方面几乎无法抵消药物不良反应对老年患者的有害影响(6例死亡和4例不可逆失能)。因此,药物不良反应似乎严重损害了老年人的生命和社会预后。

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