Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland; Institute of Pharmacology, University of Bern, Switzerland.
Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland.
Swiss Med Wkly. 2021 Jan 20;151:w20400. doi: 10.4414/smw.2021.20400. eCollection 2021 Jan 18.
Adverse drug reactions (ADRs) are an important cause of hospital admissions. Insufficient data are available about the frequency and characteristics of ADR-related emergency readmissions in Switzerland. The aim of this retrospective study was to characterise ADRs related to short-term emergency readmissions in a large Swiss University Hospital and to assess their reporting frequency.
Electronic records of all patients discharged from the University Hospital Bern within a 12-month period (1 January to 31 December 2012) and emergency readmission within 30 calendar days were reviewed. Case inclusion required a known ADR. Cases with intentional overdosing, lack of compliance or insufficient documentation were excluded. Identified ADR-related readmission cases were searched in the Swiss ADR reporting system to assess reporting rate.
There were 1294 emergency readmissions among the 4792 readmissions (14% of all admissions) within 30 days after discharge. We identified 270 cases of ADR-related readmissions, corresponding to 21% of emergency readmissions and 6% of all readmissions within 30 days. The most frequent ADRs were gastrointestinal disorders (26%), infections and infestations (19%), and nervous system disorders (10%). The most frequent drug classes leading to ADRs were antineoplastic/immunomodulating (35%) and antithrombotic agents (25%). Only 8 (3%) of the 270 cases were reported to the Swiss ADR reporting system.
ADR-related readmissions constituted a considerable part of short-term emergency readmissions. Despite being a relevant cause for rehospitalisation, only a minority of the ADRs were reported to the regulatory authorities. Strategies to prevent ADR-related readmissions and to improve reporting rates are needed.
药物不良反应（ADR）是导致住院的一个重要原因。瑞士关于 ADR 相关急诊再入院的频率和特征的数据不足。本回顾性研究的目的是描述在瑞士一家大型大学医院中与短期急诊再入院相关的 ADR，并评估其报告频率。
对 2012 年 1 月 1 日至 12 月 31 日期间在伯尔尼大学医院出院后 30 个日历日内再入院的所有患者的电子记录进行回顾。病例纳入标准为已知的 ADR。排除故意过量用药、不遵医嘱或记录不充分的病例。在瑞士 ADR 报告系统中搜索与 ADR 相关的再入院病例，以评估报告率。
在出院后 30 天内，共有 4792 例再入院中有 1294 例（所有入院的 14%）为急诊再入院。我们发现 270 例与 ADR 相关的再入院病例，占急诊再入院的 21%，所有 30 天内再入院的 6%。最常见的 ADR 为胃肠道疾病（26%）、感染和寄生虫病（19%）以及神经系统疾病（10%）。导致 ADR 的最常见药物类别为抗肿瘤/免疫调节药（35%）和抗血栓形成药（25%）。在 270 例病例中，仅有 8 例（3%）向瑞士 ADR 报告系统报告。
与 ADR 相关的再入院构成了短期急诊再入院的重要部分。尽管 ADR 是再入院的一个重要原因，但仅有少数 ADR 报告给监管机构。需要采取策略来预防与 ADR 相关的再入院并提高报告率。
