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重症监护病房患者潜在药物-药物相互作用的风险因素。

Risk factors for potential drug-drug interactions in intensive care unit patients.

机构信息

University of Kragujevac, Faculty of Medical Sciences, Pharmacology and Toxicology Department, Svetozara Markovića 69, 34000 Kragujevac, Serbia.

University of Kragujevac, Faculty of Medical Sciences, Pharmacology and Toxicology Department, Svetozara Markovića 69, 34000 Kragujevac, Serbia.

出版信息

J Crit Care. 2018 Feb;43:1-6. doi: 10.1016/j.jcrc.2017.08.021. Epub 2017 Aug 14.

Abstract

PURPOSE

To determine risk factors for each severity-based category of potential drug-drug interactions (DDIs) encountered at intensive care unit (ICU) patients.

METHODS

This was a retrospective cohort analysis of patients treated at the ICU of the Clinical Center Kragujevac, a public tertiary care hospital in Kragujevac, Serbia. Three interaction checkers were used to reveal drug-drug interactions: Medscape, Epocrates and Micromedex.

RESULTS

The study included 201 patients, 66.19±16.11 years of age. Average number of DDIs per patient ranged from 10.49±8.80 (Micromedex) to 29.43±21.51 (Medscape). Antiarrhythmic or anticonvulsant drug prescription, Charlson Comorbidity Index, male sex, length of hospitalization, number of drugs or therapeutic groups prescribed and surgery increased the risk of DDIs in ICU patients, while presence of delirium or dementia and transfer from emergency department to ICU protected against.

CONCLUSIONS

The rate of the DDIs in ICU patients at a tertiary care hospital is high, and adversely influenced by number of drugs or drug groups prescribed per patient, antiarrhythmic or anticonvulsant drug prescription, comorbidities, length of hospitalization and surgery. On the other hand, presence of cognitive deficit and transfer from emergency department to ICU protect ICU patients from the DDIs.

摘要

目的

确定重症监护病房(ICU)患者潜在药物-药物相互作用(DDI)严重程度类别相关的风险因素。

方法

这是塞尔维亚克拉古耶瓦茨临床中心 ICU 患者的回顾性队列分析,该中心是一家公立三级护理医院。使用三种药物相互作用检查器来揭示药物相互作用:Medscape、Epocrates 和 Micromedex。

结果

研究纳入 201 名患者,年龄为 66.19±16.11 岁。每位患者的平均 DDI 数量范围从 10.49±8.80(Micromedex)到 29.43±21.51(Medscape)。抗心律失常或抗惊厥药物处方、Charlson 合并症指数、男性、住院时间、开处的药物或治疗组数量和手术增加了 ICU 患者发生 DDI 的风险,而谵妄或痴呆的存在以及从急诊科转至 ICU 则起到保护作用。

结论

三级护理医院 ICU 患者的 DDI 发生率较高,并且受到每位患者处方的药物或药物组数量、抗心律失常或抗惊厥药物处方、合并症、住院时间和手术的不利影响。另一方面,认知功能缺陷的存在和从急诊科转至 ICU 可保护 ICU 患者免受 DDI 的影响。

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