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药物所致疾病作为社区医院收治的一个原因。

Drug-induced illness as a cause for admission to a community hospital.

作者信息

Colt H G, Shapiro A P

机构信息

Department of Internal Medicine, Shadyside Hospital, Pittsburgh, Pennsylvania 15232.

出版信息

J Am Geriatr Soc. 1989 Apr;37(4):323-6. doi: 10.1111/j.1532-5415.1989.tb05498.x.

Abstract

To assess the rate of occurrence of drug-induced illness as a cause for admission to the general medicine service of a community hospital, charts were reviewed retrospectively of all patients admitted to the service over two randomly selected one-month periods. Statistical analysis was performed on patients over and under the age of 65, and on iatrogenic and noniatrogenic admissions. Twenty-three of 244 patients (9.4%) were admitted with drug-induced illness. Patients with drug-induced illness had 5.7 medications as compared to 3.2 medications per patient admitted for other reasons (P less than .05). A single drug was responsible for 61% of all drug-induced illness admissions. Aspirin and other nonsteroidal anti-inflammatory agents were most often implicated. Eighteen of 155 elderly patients (11.7%) were admitted with drug-induced illness. These patients were on an average of 6.3 medications as compared with 3.8 medications per elderly patient admitted for other causes (P less than .005). Polypharmacy and a preponderantly elderly population may explain the substantial number of admissions caused by adverse drug reactions. Further research to assess the role of patient age and the number and type of medications involved in the event of drug-induced illness requires standardization of definition and diagnostic criteria.

摘要

为评估药物所致疾病作为社区医院普通内科收治原因的发生率,我们回顾性查阅了在两个随机选取的为期1个月时间段内该科室收治的所有患者的病历。对65岁及以上和65岁以下患者以及医源性和非医源性入院患者进行了统计分析。244例患者中有23例(9.4%)因药物所致疾病入院。因药物所致疾病入院的患者平均使用5.7种药物,而因其他原因入院的患者平均使用3.2种药物(P<0.05)。单一药物导致了所有药物所致疾病入院病例的61%。阿司匹林和其他非甾体抗炎药最常涉及。155例老年患者中有18例(11.7%)因药物所致疾病入院。这些患者平均使用6.3种药物,而因其他原因入院的老年患者平均使用3.8种药物(P<0.005)。多种药物治疗以及老年人口占多数可能解释了药物不良反应导致的大量入院病例。进一步研究以评估患者年龄以及药物所致疾病事件中所涉药物的数量和类型的作用,需要对定义和诊断标准进行标准化。

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