Department of Pharmacy, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Chongqing Key Laboratory of Pediatric, Children's Hospital of Chongqing Medical University, CHONGQING, 400014, China.
Department of Hematology, Children's Hospital of Chongqing Medical University, CHONGQING, 400014, China.
Sci Rep. 2018 Feb 7;8(1):2573. doi: 10.1038/s41598-018-20868-2.
Understanding the epidemiology and risk factors of adverse drug events (ADEs) in pediatric inpatient is essential if we are to prevent, reduce or ameliorate the harm experienced. The Global Trigger Tool (GTT) is a method of retrospective medical record review that measures harm in hospitalized children. We employed a three-stage retrospective chart review of random samples of 1800 pediatric inpatients discharged from January 2013 to December 2015. 31 kinds of pediatric-specific triggers were made based on the previous trigger tool studies developed for use in adult or pediatric. Positive predictive value (PPV) of individual triggers, as well as ADEs detection rates were calculated. Stepwise logistic regression was performed to investigate risk factors associated with ADEs. Of 1746 patients, detected in 221 patients (12.7%) with 247 ADEs. The PPV of the trigger tool was 13.3%. Of the 247 ADEs, 82.6% were identified as category E, 11.7% category F and 5.7% category H. The pediatric-focused trigger tool is a feasible and useful tool for detecting pediatric ADEs. Especially for patients who have had more drugs, more doses or more admissions which needs to be closely monitored as triggers to improve the safety.
了解儿科住院患者不良药物事件（ADE）的流行病学和风险因素对于预防、减少或减轻所经历的伤害至关重要。全球触发工具（GTT）是一种回顾性病历审查方法，用于衡量住院儿童的伤害程度。我们对 2013 年 1 月至 2015 年 12 月出院的 1800 名儿科住院患者进行了三阶段回顾性抽样图表审查。根据先前开发的用于成人或儿科的触发工具研究，制定了 31 种儿科特定触发因素。计算了各个触发器的阳性预测值（PPV）以及 ADE 检出率。采用逐步逻辑回归分析与 ADE 相关的危险因素。在 1746 名患者中，221 名患者（12.7%）检出 247 例 ADE。触发工具的 PPV 为 13.3%。在 247 例 ADE 中，82.6%为 E 类，11.7%为 F 类，5.7%为 H 类。以儿科为重点的触发工具是检测儿科 ADE 的一种可行且有用的工具。特别是对于那些使用了更多药物、更多剂量或更多住院治疗的患者，需要将其作为触发因素进行密切监测，以提高安全性。
