Department of Internal Medicine, Subdivision of Allergy, Chungbuk National University Hospital, Cheongju, Korea.
College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Korea.
PLoS One. 2022 Sep 19;17(9):e0272743. doi: 10.1371/journal.pone.0272743. eCollection 2022.
Adverse drug events are significant causes of emergency department visits. Systematic evaluation of adverse drug events leading to emergency department visits by age is lacking. This multicenter retrospective observational study evaluated the prevalence and features of adverse drug event-related emergency department visits across ages. We reviewed emergency department medical records obtained from three university hospitals between July 2014 and December 2014. The proportion of adverse drug events among total emergency department visits was calculated. The cause, severity, preventability, and causative drug(s) of each adverse drug event were analyzed and compared between age groups (children/adolescents [<18 years], adults [18-64 years], and the elderly [≥65 years]). Of 59,428 emergency department visits, 2,104 (3.5%) were adverse drug event-related. Adverse drug event-related emergency department visits were more likely to be female and older. Multivariate logistic regression analysis revealed that compared to non- adverse drug event-related cases, adverse drug event-related emergency department visitors were more likely to be female (60.6% vs. 53.6%, p<0.001, OR 1.285, 95% CI 1.025-1.603) and older (50.8 ± 24.6 years vs. 37.7 ± 24.4 years, p<0.001, OR 1.892, 95% CI: 1.397-2.297). Comorbidities such as diabetes, chronic kidney disease, chronic liver disease, and malignancies were also significantly associated with adverse drug event-related emergency department visits. Side effects were the most common type of adverse drug events across age groups, although main types differed substantially depending on age. Serious adverse drug events, hospitalizations, and adverse drug event-related deaths occurred more frequently in the elderly than in adults or children/adolescents. The proportion of adverse drug event-related emergency department visits that were preventable was 15.3%. Causative drugs of adverse drug events varied considerably depending on age group. Adverse drug event features differ substantially according to age group. The findings suggest that an age-specific approach should be adopted in the preventive strategies to reduce adverse drug events.
药物不良事件是急诊科就诊的重要原因。系统评估药物不良事件导致各年龄段急诊科就诊的情况尚缺乏。本多中心回顾性观察性研究评估了各年龄段与药物不良事件相关的急诊科就诊的发生率和特点。我们回顾了 2014 年 7 月至 2014 年 12 月期间三所大学附属医院的急诊科病历。计算了药物不良事件在急诊科就诊总数中的比例。分析并比较了各年龄段（儿童/青少年[<18 岁]、成年人[18-64 岁]和老年人[≥65 岁]）中药物不良事件的原因、严重程度、可预防程度和相关药物。在 59428 例急诊科就诊中，2104 例（3.5%）与药物不良事件相关。与药物不良事件相关的急诊科就诊更可能为女性和老年人。多变量逻辑回归分析显示，与非药物不良事件相关的病例相比，与药物不良事件相关的急诊科就诊者更可能为女性（60.6%比 53.6%，p<0.001，OR 1.285，95%CI 1.025-1.603）和老年人（50.8±24.6 岁比 37.7±24.4 岁，p<0.001，OR 1.892，95%CI：1.397-2.297）。糖尿病、慢性肾脏病、慢性肝病和恶性肿瘤等合并症也与与药物不良事件相关的急诊科就诊显著相关。在各年龄段，药物不良事件的最常见类型都是副作用，但主要类型因年龄而异。严重药物不良事件、住院和与药物不良事件相关的死亡在老年人中比成年人或儿童/青少年中更常见。可预防的药物不良事件相关急诊科就诊比例为 15.3%。药物不良事件的相关药物因年龄组而异。药物不良事件的特征根据年龄组而有很大差异。这些发现表明，应采用针对特定年龄段的方法来制定减少药物不良事件的预防策略。
