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受伤患者的用药错误。

Medication Errors in Injured Patients.

作者信息

Dolejs Scott C, Janowak Christopher F, Zarzaur Ben L

出版信息

Am Surg. 2017 Jul 1;83(7):780-785.

Abstract

Trauma patients are vulnerable to medication error given multiple handoffs throughout the hospital. The purpose of this study was to assess trends in medication errors in trauma patients and the role these errors play in patient outcomes. Injured adults admitted from 2009 to 2015 to a Level I trauma center were included. Medication errors were determined based on a nurse-driven, validated, and prospectively maintained database. Multivariable logistic regression modeling was used to control for differences between groups. Among 15,635 injured adults admitted during the study period, 132 patients experienced 243 errors. Patients who experienced errors had significantly worse injury severity, lower Glasgow Coma Scale scores and higher rates of hypotension on admission, and longer lengths of stay. Before adjustment, mortality was similar between groups but morbidity was higher in the medication error group. After risk adjustment, there were no significant differences in morbidity or mortality between the groups. Medication errors in trauma patients tend to occur in significantly injured patients with long hospital stays. Appropriate adjustment when studying the impact of medical errors on patient outcomes is important.

摘要

鉴于创伤患者在医院内会经历多次交接,他们容易出现用药错误。本研究的目的是评估创伤患者用药错误的趋势以及这些错误在患者预后中所起的作用。纳入了2009年至2015年入住一级创伤中心的成年伤者。用药错误是根据护士驱动、经过验证且前瞻性维护的数据库确定的。采用多变量逻辑回归模型来控制组间差异。在研究期间收治的15635名成年伤者中,132名患者出现了243次错误。出现错误的患者损伤严重程度明显更差,入院时格拉斯哥昏迷量表评分更低,低血压发生率更高,住院时间更长。在调整之前,两组之间的死亡率相似,但用药错误组的发病率更高。经过风险调整后,两组之间的发病率和死亡率没有显著差异。创伤患者的用药错误往往发生在伤势严重且住院时间长的患者身上。在研究医疗错误对患者预后的影响时进行适当调整很重要。

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