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癌症重症患者的药物不良事件:发生率、特征及结局

Adverse drug events in critically ill patients with cancer: incidence, characteristics, and outcomes.

作者信息

Nazer Lama H, Hawari Feras, Al-Najjar Taghreed

机构信息

Department of Pharmacy, King Hussein Cancer Center, Al-Jubeiha, Amman, Jordan.

出版信息

J Pharm Pract. 2014 Apr;27(2):208-13. doi: 10.1177/0897190013513302. Epub 2013 Dec 6.

Abstract

OBJECTIVE

To determine the incidence, characteristics, and outcomes of adverse drug events (ADEs) in critically ill patients with cancer.

METHODS

This was a 5-month prospective observational study. Patients who were admitted to the adult medical/surgical oncology intensive care unit (ICU) were evaluated for any drug-related adverse events during their ICU stay. An ADE was defined as injury or patient harm resulting from medical intervention related to a drug.

RESULTS

The incidence rate of ADEs was 96.5 per 1000 patient days and 35.3 per 100 ICU admissions. Of the reported ADEs, 57 (64.8%) were serious/life threatening, 30 (34.1%) were significant, 1 (1.1%) was fatal, and 14 (15.9%) of all ADEs were considered preventable. The most common drug classes associated with ADEs were antidiabetics, antibiotics, and analgesics/sedatives. The length of stay and presence of renal or respiratory failure were significantly associated with an increased number of ADEs. The length of stay and female sex were significantly associated with the likelihood of developing an ADE.

CONCLUSION

Critically ill patients with cancer are at high risk of developing ADEs. Strategies that reduce the incidence and severity of ADEs are essential to improve the outcomes of this patient population.

摘要

目的

确定癌症重症患者药物不良事件(ADEs)的发生率、特征及结局。

方法

这是一项为期5个月的前瞻性观察性研究。对入住成人内科/外科肿瘤重症监护病房(ICU)的患者在其ICU住院期间的任何药物相关不良事件进行评估。ADE被定义为与药物相关的医疗干预导致的伤害或患者损害。

结果

ADEs的发生率为每1000患者日96.5例,每100例ICU入院患者中有35.3例。在报告的ADEs中,57例(64.8%)为严重/危及生命,30例(34.1%)为显著,1例(1.1%)为致命,所有ADEs中有14例(15.9%)被认为是可预防的。与ADEs相关的最常见药物类别是抗糖尿病药、抗生素和镇痛药/镇静剂。住院时间以及存在肾或呼吸衰竭与ADEs数量增加显著相关。住院时间和女性性别与发生ADEs的可能性显著相关。

结论

癌症重症患者发生ADEs的风险很高。降低ADEs发生率和严重程度的策略对于改善该患者群体的结局至关重要。

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