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药物不良反应相关住院风险在出院后的持续存在。

Persistence of Adverse Drug Reaction-Related Hospitalization Risk Following Discharge.

机构信息

School of Pharmacy and Pharmacology, University of Tasmania, Hobart, TAS 7001, Australia.

Tasmanian School of Medicine, University of Tasmania, Hobart, TAS 7000, Australia.

出版信息

Int J Environ Res Public Health. 2022 May 4;19(9):5585. doi: 10.3390/ijerph19095585.

Abstract

This retrospective cohort study analyzed the administrative hospital records of 91,500 patients with the aim of assessing adverse drug reaction (ADR)-related hospital admission risk after discharge from ADR and non-ADR-related admission. Patients aged ≥18 years with an acute admission to public hospitals in Tasmania, Australia between 2011 and 2015 were followed until May 2017. The index admissions (n = 91,550) were stratified based on whether they were ADR-related (n = 2843, 3.1%) or non-ADR-related (n = 88,707, 96.9%). Survival analysis assessed the post-index ADR-related admission risk using (1) the full dataset, and (2) a matched subset of patients using a propensity score analysis. Logistic regression was used to identify the risk factors for ADR-related admissions within 90 days of post-index discharge. The patients with an ADR-related index admission were almost five times more likely to experience another ADR-related admission within 90 days (p < 0.001). An increased risk persisted for at least 5 years (p < 0.001), which was substantially longer than previously reported. From the matched subset of patients, the risk of ADR-related admission within 90 and 365 days more than doubled in the patients with an ADR-related index admission (p < 0.0001). These admissions were often attributed to the same drug class as the patients’ index ADR-related admission. Cancer was a major risk factor for ADR-related re-hospitalization within 90 days; other factors included heart failure and increasing age.

摘要

这项回顾性队列研究分析了 91500 名患者的医院管理记录,旨在评估药物不良反应(ADR)相关出院后和非 ADR 相关入院的不良药物反应(ADR)相关入院风险。2011 年至 2015 年间,澳大利亚塔斯马尼亚州公立医院急性入院的年龄≥18 岁的患者被随访至 2017 年 5 月。根据是否与 ADR 相关(n=2843,3.1%)或非 ADR 相关(n=88707,96.9%),将指数入院(n=91550)分层。使用(1)完整数据集和(2)使用倾向评分分析的患者匹配子集评估指数后 ADR 相关入院风险的生存分析。使用逻辑回归确定指数后出院 90 天内 ADR 相关入院的风险因素。与 ADR 相关的指数入院患者在 90 天内再次发生 ADR 相关入院的可能性几乎高出五倍(p<0.001)。至少在 5 年内持续存在风险(p<0.001),这比之前报道的时间要长得多。从匹配的患者子集来看,与 ADR 相关的指数入院患者在 90 天和 365 天内发生 ADR 相关入院的风险增加了一倍以上(p<0.0001)。这些入院通常归因于与患者指数 ADR 相关入院相同的药物类别。癌症是 ADR 相关再入院 90 天内的主要危险因素;其他因素包括心力衰竭和年龄增长。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4a5/9101512/9f5eea9caafb/ijerph-19-05585-g0A1.jpg

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