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老年住院患者潜在药物相互作用与死亡率之间的关系。

The relationship between potential drug-drug interactions and mortality rate of elderly hospitalized patients.

作者信息

Rosas-Carrasco Oscar, García-Peña Carmen, Sánchez-García Sergio, Vargas-Alarcón Gilberto, Gutiérrez-Robledo Luis Miguel, Juárez-Cedillo Teresa

机构信息

Epidemiologic and Health Service Research Unit, Aging Area, Centro Médico Nacional Siglo XXI, IMSS, México.

出版信息

Rev Invest Clin. 2011 Nov-Dec;63(6):564-73.

Abstract

BACKGROUND

The increase in drug-drug interactions (potential DDIs) is a consequence that older adults experience by high availability of prescription medications for an increasing variety of diseases. This increase in potential DDIs could be associated with mortality rate during hospitalization.

OBJECTIVE

To determine whether the association between the presence of Potential DDIs and mortality rate in hospitalized elderly and to describe the frequency of potential DDIs and characterize drugs.

MATERIAL AND METHODS

A retrospective research was performed by reviewing the medical records of patients 60 years and older who were admitted to a second-level care hospital. The Potential DDIs were identified through the Micromedex program. Comorbidity was classified according to the Charlson Index (CCI). Other variables such as gender, age, number and type of drug, type of interaction, and duration of hospital stay were evaluated.

RESULTS

505 patients were included, among whom the 62.77% presented at least one type of DDI. We found that 15.25% of moderate interactions were due to the combined use of angiotensin converting enzyme inhibitors and loop diuretics. Among serious interactions, 14.92% occurred due to the combined use of fluroquinolones and hypoglycemic agents. The duration of stay and a high comorbidity score, the presence of three or more interactions and exposure time to the interaction, were independently associated with mortality rate.

CONCLUSIONS

This work shows that the occurrence of potential DDIs in the hospital environment for the elderly population is frequent and may be implicated in the cause of death for these patients.

摘要

背景

药物相互作用(潜在药物相互作用)的增加是老年人因针对越来越多疾病的处方药高可用性而经历的一个结果。这种潜在药物相互作用的增加可能与住院期间的死亡率相关。

目的

确定住院老年人中潜在药物相互作用的存在与死亡率之间的关联,并描述潜在药物相互作用的频率和药物特征。

材料与方法

通过回顾一家二级护理医院收治的60岁及以上患者的病历进行回顾性研究。通过Micromedex程序识别潜在药物相互作用。根据查尔森指数(CCI)对合并症进行分类。评估其他变量,如性别、年龄、药物数量和类型、相互作用类型以及住院时间。

结果

纳入505例患者,其中62.77%至少出现一种类型的药物相互作用。我们发现15.25%的中度相互作用是由于联合使用血管紧张素转换酶抑制剂和袢利尿剂所致。在严重相互作用中,14.92%是由于联合使用氟喹诺酮类药物和降糖药物所致。住院时间和高合并症评分、三种或更多相互作用的存在以及相互作用的暴露时间与死亡率独立相关。

结论

这项研究表明,老年人群在医院环境中潜在药物相互作用的发生很频繁,可能与这些患者的死亡原因有关。

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