Adverse Drug Reactions in Hospital In-Patients A Prospective Analysis of 3695 Patient-Episodes 英文参考文献.docVIP

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Adverse Drug Reactions in Hospital In-Patients A Prospective Analysis of 3695 Patient-Episodes 英文参考文献.doc

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Adverse Drug Reactions in Hospital In-Patients A Prospective Analysis of 3695 Patient-Episodes 英文参考文献

AdverseDrugReactionsinHospitalIn-Patients:A ProspectiveAnalysisof3695Patient-Episodes EmmaC.Davies1,2,ChristopherF.Green3,StephenTaylor4,PaulaR.Williamson4,DavidR.Mottram2, MunirPirmohamed5* 1TheRoyal Liverpool andBroadgreenUniversityHospitalsTrust, Liverpool,United Kingdom, 2SchoolofPharmacy andChemistry, Liverpool JohnMoores University, Liverpool, United Kingdom, 3Countess of Chester NHS Foundation Trust, Pharmacy: Martindale House, Countess of Chester Health Park, Chester, United Kingdom, 4CentreforMedicalStatisticsandHealthEvaluation,UniversityofLiverpool,Liverpool,UnitedKingdom,5DepartmentofPharmacologyandTherapeutics,TheUniversity ofLiverpool,Liverpool,UnitedKingdom Abstract Adverse drug reactions (ADRs) are a major cause of hospital admissions, but recent data on the incidence and clinical characteristicsofADRswhichoccurfollowinghospitaladmission,arelacking.Patientsadmittedtotwelvewardsoverasix- monthperiodin2005wereassessedforADRsthroughouttheiradmission.SuspectedADRswererecordedandanalysedfor causality,severityandavoidabilityandwhethertheyincreasedthelengthofstay.Multivariableanalysiswasundertakento identifytheriskfactorsforADRs.The5%significancelevelwasusedwhenassessingfactorsforinclusioninmultivariable models. Out of the 3695 patient episodes assessed for ADRs, 545 (14.7%, 95% CI 13.6–15.9%) experienced one or more ADRs. Half of ADRs were definitely or possibly avoidable. The patients experiencing ADRs were more likely to be older, female,takingalargernumberofmedicines,andhadalongerlengthofstaythanthosewithoutADRs.However,theonly significant predictor of ADRs, from the multivariable analysis of a representative sample of patients, was the number of medicinestakenbythepatientwitheachadditionalmedicationmultiplyingthehazardofanADRepisodeby1.14(95%CI 1.09,1.20).ADRsdirectlyincreasedlengthofstayin147(26.8%)patients.ThedrugsmostfrequentlyassociatedwithADRs were diuretics, opioid analgesics, and anticoagulants. In conclusion, approximately one in seven hos