School of Pharmacy and Pharmacology, University of Tasmania, Hobart, TAS 7001, Australia.
Tasmanian School of Medicine, University of Tasmania, Hobart, TAS 7000, Australia.
Int J Environ Res Public Health. 2022 May 4;19(9):5585. doi: 10.3390/ijerph19095585.
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.
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。
