국내 한 상급종합병원의 입원환자 대상 약물이 상반응현황 분석
Trends of Adverse Drug Reactions (ADRs)-Related Admissions and Hospital Acquired ADRs in a Korean Tertiary Hospital
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Background : Adverse drug reactions (ADRs) are a substantial causes of hospital admission. However, representative data on ADRs that result in hospitalization have been limited and little is known about the incidence, preventability, and severity of ADRs. Methods : Identification of ADR related admissions and hospital acquired ADR from EMR(electronicmedical records) database was based on KCD-6 (Korean Statistical Classification of Diseases and Related Health Problems) codes. We selected all hospitalizations that were coded as drug-related (codes Y40~Y59) for the period of January 2009-December 2011 in a Korean tertiary hospital. Results : During the 2009-2011 periods, the total number of hospitalized patients with ADR and hospital acquired ADR was 493 individuals. Among all hospital admissions, 0.21% were found to be induced ADR. In patients who experienced an ADR, hospital acquired ADRs were 24.3%, and 75.7% were ADR related admissions. The age group most commonly associated with ADRs was 60~69 years (23.5%). The highest percentage of ADRs related admission among all the patients by age group was 0.38% for patients aged 80 and over. Differences in ADR symptoms were statistically significant for gastric disorders. The most common drug classes associated with ADRs were J01 (Antibacterials) which accounted for 40.5% in hospital acquired ADRs and L01 (Antineoplastic agent), 41.3% in ADRs related admission. The drugs most commonly associated with ADRs related admissions were Aspirin (n= 22), Cisplatin, Prednisolone, Doxorubicine, Rifampicin and hospital acquired ADRs were Vancomycin (n= 25), Piperacillin/Tazobactam, Methotrexate, Amphotericin B. Conclusions : ADRs related admission and hospital acquired ADRs were different in causative drug and symptom manifestation. In our study, we showed that elderly patients aged ≥80 years were at increased risk of an ADRs related hospitalization. These findings will enable pharmacists to develop better management programs for ADRs. Improved management of antibacterials and antineoplastic agents has the potential to reduced hospitalizations for ADRs in older adults.
Abstract
Background : Adverse drug reactions (ADRs) are a substantial causes of hospital admission. However, representative data on ADRs that result in hospitalization have been limited and little is known about the incidence, preventability, and severity of ADRs. Methods : Identification of ADR related admissions and hospital acquired ADR from EMR(electronicmedical records) database was based on KCD-6 (Korean Statistical Classification of Diseases and Related Health Problems) codes. We selected all hospitalizations that were coded as drug-related (codes Y40~Y59) for the period of January 2009-December 2011 in a Korean tertiary hospital. Results : During the 2009-2011 periods, the total number of hospitalized patients with ADR and hospital acquired ADR was 493 individuals. Among all hospital admissions, 0.21% were found to be induced ADR. In patients who experienced an ADR, hospital acquired ADRs were 24.3%, and 75.7% were ADR related admissions. The age group most commonly associated with ADRs was 60~69 years (23.5%). The highest percentage of ADRs related admission among all the patients by age group was 0.38% for patients aged 80 and over. Differences in ADR symptoms were statistically significant for gastric disorders. The most common drug classes associated with ADRs were J01 (Antibacterials) which accounted for 40.5% in hospital acquired ADRs and L01 (Antineoplastic agent), 41.3% in ADRs related admission. The drugs most commonly associated with ADRs related admissions were Aspirin (n= 22), Cisplatin, Prednisolone, Doxorubicine, Rifampicin and hospital acquired ADRs were Vancomycin (n= 25), Piperacillin/Tazobactam, Methotrexate, Amphotericin B. Conclusions : ADRs related admission and hospital acquired ADRs were different in causative drug and symptom manifestation. In our study, we showed that elderly patients aged ≥80 years were at increased risk of an ADRs related hospitalization. These findings will enable pharmacists to develop better management programs for ADRs. Improved management of antibacterials and antineoplastic agents has the potential to reduced hospitalizations for ADRs in older adults.
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