65岁以上患者因药物不良反应导致的医院再入院情况。
Hospital re-admission associated with adverse drug reactions in patients over the age of 65 years.
作者信息
Hauviller Laurent, Eyvrard Frédéric, Garnault Valérie, Rousseau Vanessa, Molinier L, Montastruc Jean Louis, Bagheri Haleh
机构信息
Service de Pharmacologie Médicale et Clinique, Centre Midi-Pyrénées de Pharmacovigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament, Faculté de Médecine de l'Université Paul Sabatier-, INSERM U1027, 37 Allées Jules Guesde, 31000, Toulouse, France.
Département d'Informations Médicales, CHU Toulouse, Hôtel Dieu St Jacques, 2 Rue Viguerie, 31300, Toulouse, France.
出版信息
Eur J Clin Pharmacol. 2016 May;72(5):631-9. doi: 10.1007/s00228-016-2022-4. Epub 2016 Feb 17.
CONTEXT
Adverse drug reactions (ADRs) are responsible for 5 % of hospital admissions, but hospital re-admission induced by ADRs remains poorly documented.
OBJECTIVE
The aim of this study was to estimate the rate of hospital re-admission and the factors associated with re-admission in the patients over the age of 65 years. Secondary, we described the characteristics of cases of ADRs leading to re-admission for drugs other than chemotherapy agents.
METHODS
Data were extracted from hospital discharge summaries provided by the Department of Medical Information of Toulouse University Hospital. All patients over the age of 65 years admitted to the hospital in 2010 for an ADR, identified from ICD-10 codes, were selected. All subsequent admissions of members of this cohort within 1 year of discharge following the index admission were reviewed retrospectively. The risk factors associated with hospital re-admission for ADRs were analyzed. Medical records were used for descriptive analysis of re-admission due to drugs other than chemotherapy agents.
RESULTS
We found that 553 of the 1000 patients admitted for ADRs in 2010 were re-admitted to hospital within 1 year. Among them, 87 cases were re-admitted for ADRs (estimated rate of 87/1000 re-admission for an ADR within 1 year). A comparison of the patients re-admitted for ADRs (n = 87) with those of patients re-admitted for other causes (n = 410) suggested that only cancer increased the risk of re-admission for ADRs (OR = 7.69 [4.59-12.88] 95 % CI). ADRs due to the same drug combination were the suspected cause of repeat admission in half the cases (other than chemotherapy). Hospital re-admission was considered avoidable in four cases (22 %).
CONCLUSION
This study shows an estimated rate of re-admission for an ADR around 87/1000 within 1 year, and the same drug combination were the suspected cause of repeat admission in half the cases. At least, 11 % of cases were avoidable.
背景
药物不良反应（ADR）导致5%的住院病例，但由ADR引起的再次住院情况记录仍不完善。
目的
本研究旨在评估65岁以上患者再次住院率及与再次住院相关的因素。其次，我们描述了导致除化疗药物外其他药物再次住院的ADR病例特征。
方法
数据从图卢兹大学医院医学信息部提供的出院小结中提取。选取2010年因ADR入院的所有65岁以上患者，通过国际疾病分类第十版（ICD - 10）编码识别。对该队列成员在首次入院出院后1年内的所有后续入院情况进行回顾性审查。分析与ADR再次住院相关的危险因素。使用病历对除化疗药物外其他药物导致的再次住院进行描述性分析。
结果
我们发现，2010年因ADR入院的1000名患者中有553人在1年内再次入院。其中，87例因ADR再次入院（估计1年内ADR再次入院率为87/1000）。将因ADR再次入院的患者（n = 87）与因其他原因再次入院的患者（n = 410）进行比较，结果表明只有癌症增加了因ADR再次入院的风险（比值比[OR]=7.69[4.59 - 12.88]，95%置信区间）。在一半的病例中（除化疗外），因相同药物组合导致的ADR被怀疑是再次入院的原因。4例（22%）再次住院被认为是可避免的。
结论
本研究显示，1年内ADR再次入院估计率约为87/1000，且一半的病例中相同药物组合被怀疑是再次入院的原因。至少11%的病例是可避免的。
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