基于人群的研究表明，急性肾衰竭（ARF）与多药治疗持续时间之间存在关联。
A population-based study on the association between acute renal failure (ARF) and the duration of polypharmacy.
机构信息
Department of Nephrology, Taoyuan Veterans Hospital, 100 Cheng Kong Rd, Sec. 3, Taoyuan City 33010, Taiwan.
出版信息
BMC Nephrol. 2012 Aug 30;13:96. doi: 10.1186/1471-2369-13-96.
BACKGROUND
Because of the rapid growth in elderly population, polypharmacy has become a serious public health issue worldwide. Although acute renal failure (ARF) is one negative consequence of polypharmacy, the association between the duration of polypharmacy and ARF remains unclear. We therefore assessed this association using a population-based database.
METHODS
Data were collected from the Taiwan National Health Insurance Research Database (NHIRD) from 2003 through 2006. The case group included patients hospitalized for ARF during 2006, but not admitted due to trauma, surgery, burn trauma, car accident, transplantation, or infectious diseases; the control group included patients hospitalized without ARF. The cumulative number of days of polypharmacy (defined as more than 5 prescriptions per day) for 1 year prior to admission was determined, with patients further subdivided into 4 categories: less than 30 days, 31-90 days, 91-180 days, and over 181 days. The dependent variable was ARF, and the control variables were age, gender, comorbidities in patients hospitalized for ARF, stay in ICUs during ARF hospitalization and site of operation for prior admissions within one month of ARF hospitalization.
RESULTS
Of 20,790 patients who were admitted to hospitals for ARF in 2006, 12,314 (59.23 %) were male and more than 60 % were older than 65 years. Of patients with and without ARF, 16.14 % and 10.61 %, respectively, received polypharmacy for 91-180 days and 50.22 % and 24.12 %, respectively, for over 181 days. A statistical model indicated that, relative to patients who received polypharmacy for less than 30 days, those who received polypharmacy for 31-90, 91-180 and over 181 days had odds ratios of developing ARF of 1.33 (p<0.001), 1.65 (p<0.001) and 1.74 (p<0.001), respectively.
CONCLUSIONS
We observed statistically significant associations between the duration of polypharmacy and the occurrence of ARF.
背景
由于老年人口的快速增长，多种药物治疗已成为全球严重的公共卫生问题。虽然急性肾衰竭（ARF）是多种药物治疗的一个负面后果，但多种药物治疗的持续时间与 ARF 之间的关系尚不清楚。因此，我们使用基于人群的数据库对此进行了评估。
方法
数据来自 2003 年至 2006 年的台湾全民健康保险研究数据库（NHIRD）。病例组包括 2006 年因 ARF 住院的患者，但因创伤、手术、烧伤、车祸、移植或传染病而未入院；对照组包括未患 ARF 的住院患者。确定入院前 1 年每天服用 5 种以上药物的累积天数，将患者进一步分为 4 类：少于 30 天、31-90 天、91-180 天和超过 181 天。因变量为 ARF，控制变量为年龄、性别、ARF 住院患者的合并症、ARF 住院期间入住 ICU 以及 ARF 住院前一个月内的先前入院手术部位。
结果
在 2006 年因 ARF 住院的 20790 名患者中，12314 名（59.23%）为男性，超过 60%的患者年龄大于 65 岁。在有和没有 ARF 的患者中，分别有 16.14%和 10.61%接受了 91-180 天的多种药物治疗，分别有 50.22%和 24.12%接受了超过 181 天的多种药物治疗。统计模型表明，与接受少于 30 天的多种药物治疗的患者相比，接受 31-90、91-180 和超过 181 天的多种药物治疗的患者发生 ARF 的优势比分别为 1.33（p<0.001）、1.65（p<0.001）和 1.74（p<0.001）。
结论
我们观察到多种药物治疗的持续时间与 ARF 的发生之间存在统计学显著关联。
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