Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang, Malaysia.
Drugs Aging. 2012 Aug 1;29(8):669-79. doi: 10.1007/BF03262282.
The aims of the study were to determine the rates, types, severity and preventability of adverse drug reactions (ADRs) in a hospitalized population of very elderly patients (over 80 years of age) and to identify factors that predispose the very elderly to an ADR.
An observational study was conducted in patients over 80 years of age admitted to four care of the elderly wards in Brighton and Sussex University Hospitals NHS Trust. The main outcome measures were the incidence of ADRs during inpatient stay in older patients and the identification of the major drug classes involved and the risk factors contributing to the occurrence of ADRs.
A total of 560 very elderly patients were recruited, 74 of whom experienced one or more ADR (83 in total), representing an incidence of 13.2% (95% CI 10.4, 16). Sixty-three percent of all ADRs were considered preventable, with 57 classified as serious and three as life threatening. The drug classes frequently implicated in ADRs were cardiovascular agents (34%), analgesic medications (18%) and anti-diabetic drugs (10%). Five variables were established as independent predictors of ADRs: number of medications, use of hypoglycaemic agents, history of hyperlipidaemia, raised white cell count on admission, and length of stay.
The ADR incidence reported in this population was no greater than that seen in other studies for both general medical patients and those elderly patients over 65 years of age. A significant proportion of ADRs were preventable, and this suggests that closer monitoring of high-risk elderly patients is needed to address this problem.
本研究旨在确定高龄患者（80 岁以上）住院人群中不良反应（ADR）的发生率、类型、严重程度和可预防程度，并确定使高龄患者易发生 ADR 的因素。
在布莱顿和苏塞克斯大学医院 NHS 信托的四个老年护理病房中，对 80 岁以上的住院患者进行了一项观察性研究。主要观察指标为老年患者住院期间 ADR 的发生率，以及确定涉及的主要药物类别和导致 ADR 发生的危险因素。
共招募了 560 名高龄患者，其中 74 名（83 名）发生了 1 次或多次 ADR，发生率为 13.2%（95%CI10.4，16）。所有 ADR 中有 63%被认为是可预防的，其中 57 例为严重，3 例为危及生命。与 ADR 相关的药物类别频繁涉及心血管药物（34%）、镇痛药（18%）和抗糖尿病药物（10%）。有 5 个变量被确定为 ADR 的独立预测因素：用药数量、使用降血糖药、高脂血症史、入院时白细胞计数升高和住院时间。
本研究报告的 ADR 发生率与其他普通内科患者和 65 岁以上老年患者的研究相似。相当一部分 ADR 是可以预防的，这表明需要对高危老年患者进行更密切的监测，以解决这一问题。
