The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, NSW, Australia.
The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, NSW, Australia; NSW Poisons Information Centre, The Children's Hospital at Westmead, Sydney, Australia.
Res Social Adm Pharm. 2022 Jul;18(7):3184-3190. doi: 10.1016/j.sapharm.2021.09.003. Epub 2021 Sep 14.
Adverse drug events (ADEs) remain a key contributor to hospitalisations, resulting in long hospital stays and readmissions. Information pertaining to the specific medications and clinical factors associated with these outcomes is limited. Hence, a better understanding of these factors and their relationship to ADEs is required.
To investigate medications involved, clinical manifestations of ADE-related hospitalisations, and their association with length of stay and readmission.
A retrospective medical record review of patients admitted to a major, tertiary referral hospital in NSW, Australia, from January 2019 to August 2020 was conducted. ADEs were identified using Australian Refined Diagnosis Related Group (AR-DRG) codes: X40, X61, X62 and X64. Medications were classified per the Anatomical Therapeutic Chemical (ATC) classification system and clinical symptoms were classified per the International Classification of Disease (ICD) 9-CM. Logistic regression was performed to assess the relationship between medication and presentation classes with length of stay (≥2 days vs <2 days) and readmission.
There were 125 patients who met inclusion criteria (median age = 64 [interquartile range, 45-75] years; 53.6% male). Anti-thrombotic agents, opioids, antidepressants, antipsychotics, insulins and NSAIDs were the most implicated pharmacological classes. Neurological medications and falls were associated with a length of stay ≥2 days (adjusted odds ratio [aOR] 3.92, 95% confidence interval [CI] 1.48-10.33 and aOR 3.24, 95% CI 1.05-10.06, respectively). Neurological medications and neurological and cognitive disorders were associated with an increased likelihood of 90-day readmission (aOR 2.63, 95% CI 1.05-6.57 and aOR 3.20, 95% CI 1.17-8.75, respectively).
This study identified neurological medications as high-risk for increased length of stay and readmission in those hospitalised due to ADEs. This highlights the need for judicious prescribing and monitoring of these medications.
药物不良反应（ADE）仍然是导致住院的主要原因之一，导致住院时间延长和再次入院。与这些结果相关的特定药物和临床因素的信息有限。因此，需要更好地了解这些因素及其与 ADE 的关系。
调查涉及的药物、与 ADE 相关的住院临床表现，以及它们与住院时间和再次入院的关系。
对 2019 年 1 月至 2020 年 8 月期间在澳大利亚新南威尔士州一家主要的三级转诊医院住院的患者进行回顾性病历审查。使用澳大利亚改良诊断相关组（AR-DRG）代码：X40、X61、X62 和 X64 来识别 ADE。药物按解剖治疗化学（ATC）分类系统分类，临床症状按国际疾病分类（ICD）9-CM 分类。采用逻辑回归评估药物和表现类别的关系与住院时间（≥2 天与<2 天）和再入院的关系。
符合纳入标准的患者有 125 名（中位数年龄 64 [四分位距 45-75]岁；53.6%为男性）。抗血栓药物、阿片类药物、抗抑郁药、抗精神病药、胰岛素和 NSAIDs 是最常见的药理学类别。神经药物和跌倒与住院时间≥2 天有关（调整后的优势比 [aOR] 3.92，95%置信区间 [CI] 1.48-10.33 和 aOR 3.24，95% CI 1.05-10.06）。神经药物和神经和认知障碍与 90 天再入院的可能性增加有关（aOR 2.63，95% CI 1.05-6.57 和 aOR 3.20，95% CI 1.17-8.75）。
本研究确定神经药物是导致因 ADE 住院患者住院时间延长和再次入院的高风险因素。这凸显了谨慎处方和监测这些药物的必要性。
