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儿科住院患者药物不良反应的危险因素:一项队列研究。

Risk factors for adverse drug reactions in pediatric inpatients: A cohort study.

作者信息

Andrade Paulo Henrique Santos, Lobo Iza Maria Fraga, da Silva Wellington Barros

机构信息

Universidade Federal de Sergipe, São Cristóvão, Sergipe, Brazil.

Hospital Universitário de Sergipe, Aracaju, Sergipe, Brazil.

出版信息

PLoS One. 2017 Aug 1;12(8):e0182327. doi: 10.1371/journal.pone.0182327. eCollection 2017.

Abstract

PURPOSE

The present study aims to identify the risk factors for adverse drug reactions (ADR) in pediatric inpatients.

METHODS

A prospective cohort study in one general pediatric ward in a hospital in Northeast Brazil was conducted in two stages: the first stage was conducted between August 17th and November 6th, 2015, and the second one between March 1st and August 25th, 2016. We included children aged 0-14 years 11 months hospitalized with a minimum stay of 48 hours. Observed outcomes were the ADR occurrence and the time until the first ADR observed. In the univariate analysis, the time to the first ADR was compared among groups using a log-rank test. For the multivariate analysis, the Cox regression model was used.

RESULTS

A total of 173 children (208 admissions) and 66 ADR classified as "definite" and "probable" were identified. The incidence rate was 3/100 patient days. The gastro-intestinal system disorders were the main ADR observed (28.8%). In addition, 22.7% of the ADR were related to antibacterials for systemic use and 15.2% to general anesthesia. Prior history of ADR of the child [hazard ratio (HR) 2.44; 95% confidence interval (CI) 1.19-5.00], the use of meglumine antimonate (HR 4.98; 95% CI 1.21-20.54), antibacterial for systemic use (HR 2.75; 95% CI 1.08-6.98) and antiepileptic drugs (HR 3.84; 95% CI 1.40-10.56) were identified risk factors for ADR.

CONCLUSIONS

We identified as risk factors the prior history of ADR of the child and the use of meglumine antimonate, antibacterial for systemic use and antiepileptic drugs.

摘要

目的

本研究旨在确定儿科住院患者药物不良反应(ADR)的危险因素。

方法

在巴西东北部一家医院的一个普通儿科病房进行了一项前瞻性队列研究,分为两个阶段:第一阶段于2015年8月17日至11月6日进行,第二阶段于2016年3月1日至8月25日进行。我们纳入了年龄在0至14岁11个月之间、住院时间至少为48小时的儿童。观察的结果是ADR的发生情况以及首次观察到ADR的时间。在单因素分析中,使用对数秩检验比较各组首次出现ADR的时间。对于多因素分析,使用Cox回归模型。

结果

共识别出173名儿童(208次入院)以及66例被归类为“肯定”和“很可能”的ADR。发病率为3/100患者日。观察到的主要ADR为胃肠道系统疾病(28.8%)。此外,22.7%的ADR与全身用抗菌药物有关,15.2%与全身麻醉有关。儿童既往ADR史[风险比(HR)2.44;95%置信区间(CI)1.19 - 5.00]、使用葡甲胺锑酸盐(HR 4.98;95% CI 1.21 - 20.54)、全身用抗菌药物(HR 2.75;95% CI 1.08 - 6.98)和抗癫痫药物(HR 3.84;95% CI 1.40 - 10.56)被确定为ADR的危险因素。

结论

我们确定儿童既往ADR史以及使用葡甲胺锑酸盐、全身用抗菌药物和抗癫痫药物为危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f9e/5538648/ca1c8e097cb1/pone.0182327.g001.jpg

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