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社区获得性肺炎患者药物相互作用对住院时间的影响。

The Impact of Drug Interactions in Patients with Community-Acquired Pneumonia on Hospital Length of Stay.

作者信息

Schmitt Johannes Peter, Kirfel Andrea, Schmitz Marie-Therese, Kohlhof Hendrik, Weisbarth Tobias, Wittmann Maria

机构信息

Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.

Department of Medical Biometry, Informatics and Epidemiology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.

出版信息

Geriatrics (Basel). 2022 Jan 4;7(1):11. doi: 10.3390/geriatrics7010011.

Abstract

(1) Background: An aging society is frequently affected by multimorbidity and polypharmacy, which, in turn, leads to an increased risk for drug interaction. The aim of this study was to evaluate the influence of drug interactions on the length of stay (LOS) in hospitals. (2) Methods: This retrospective, single-centre study is based on patients treated for community-acquired pneumonia in the hospital. Negative binomial regression was used to analyse the association between drug interactions and the LOS in the hospital. (3) Results: The total cohort contained 503 patients, yet 46 inpatients (9%) that died were not included in the analyses. The mean age was 74 (±15.3) years, 35% of patients older than 65 years were found to have more than two drug interactions, and 55% had a moderate, severe, or contraindicated adverse drug reaction. The regression model revealed a significant association between the number of drug interactions (rate ratio (RR) 1.02; 95%-CI 1.01-1.04) and the severity of drug interactions (RR 1.22; 95%-CI 1.09-1.37) on the LOS for the overall cohort as well as for the subgroup of patients aged 80 years and older. (4) Conclusion: Drug interactions are an independent risk factor for prolonged hospitalisation. Standardised assessment tools to avoid drug interactions should be implemented in clinical routines.

摘要

(1) 背景:老龄化社会经常受到多种疾病和多种药物治疗的影响,这反过来又会增加药物相互作用的风险。本研究的目的是评估药物相互作用对住院时间(LOS)的影响。(2) 方法:这项回顾性单中心研究基于在医院接受社区获得性肺炎治疗的患者。采用负二项回归分析药物相互作用与住院时间之间的关联。(3) 结果:总队列包括503名患者,但46名死亡的住院患者(9%)未纳入分析。平均年龄为74(±15.3)岁,发现35%年龄超过65岁的患者有两种以上药物相互作用,55%有中度、重度或禁忌的药物不良反应。回归模型显示,总体队列以及80岁及以上患者亚组中,药物相互作用的数量(率比(RR)1.02;95%置信区间1.01 - 1.04)和药物相互作用的严重程度(RR 1.22;95%置信区间1.09 - 1.37)与住院时间之间存在显著关联。(4) 结论:药物相互作用是延长住院时间的独立危险因素。应在临床常规中实施标准化评估工具以避免药物相互作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23ad/8788264/2b81bff56517/geriatrics-07-00011-g001.jpg

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