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住院患者跌倒与增加跌倒风险药物(FRIDs)剂量之间的关联。

Associations between doses of fall-risk-increasing drugs (FRIDs) and falls of hospitalized patients.

机构信息

Department of Physical Medicine and Rehabilitation, Changhua Christian Hospital, 135 Nanhsiao Street, Changhua City, 50006, Taiwan, ROC.

Big Data Center, Changhua Christian Hospital, Changhua City, Taiwan, ROC.

出版信息

Sci Rep. 2023 Sep 1;13(1):14380. doi: 10.1038/s41598-023-41568-6.

Abstract

Falls are a serious public health problem in the aging population because of the associated clinical and socioeconomic impact. Although previous studies have investigated fall-risk-increasing drugs (FRIDs), few studies have focused on dosage among adult inpatients. This study aimed to evaluate associations between fall risk and dosage of different FRIDs classes in hospital inpatients. Inpatients who experienced falls at medical or surgical wards of Changhua Christian Hospital from January 2017 to December 2021 were identified and matched by age, sex, and hospital ward to randomly selected controls (four per case). Anonymous patient data were extracted from the hospital medical data repository, including demographic characteristics, comorbidities, fall-risk scores, and drug prescriptions. Medication dosages were computed using the anatomical therapeutic chemical classification and the defined daily dose system of the World Health Organization. A total of 852 cases and 3408 controls were identified as eligible. Reducing the use of CNS-active medications, administering lower doses of sedative-hypnotics, prescribing sufficient dopaminergic anti-Parkinson agents, and using NSAIDs instead of opioids are imperative in preventing falls among hospitalized patients according to the findings in the study.

摘要

跌倒在老年人群体中是一个严重的公共卫生问题,因为其与临床和社会经济学方面的影响有关。尽管先前的研究已经调查了增加跌倒风险的药物(FRIDs),但很少有研究关注成年住院患者的剂量。本研究旨在评估住院患者中不同 FRIDs 类别的跌倒风险与剂量之间的关联。从 2017 年 1 月至 2021 年 12 月,从彰化基督教医院的内科和外科病房中确定了跌倒的住院患者,并按照年龄、性别和医院病房与随机选择的对照者(每例 4 例)进行匹配。从医院医疗数据存储库中提取匿名患者数据,包括人口统计学特征、合并症、跌倒风险评分和药物处方。药物剂量使用解剖治疗化学分类和世界卫生组织的定义日剂量系统进行计算。共有 852 例病例和 3408 例对照者被确定为符合条件。根据研究结果,减少中枢神经系统活性药物的使用、给予较低剂量的镇静催眠药、开足够的多巴胺能抗帕金森药物以及使用非甾体抗炎药而不是阿片类药物对预防住院患者跌倒至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7625/10474018/5bc428866ec6/41598_2023_41568_Fig1_HTML.jpg

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