Clinical factors associated with increased length of stay and readmission in patients with medication-related hospital admissions: a retrospective study.

Autor: Wojt IR; The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, NSW, Australia., Cairns R; The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, NSW, Australia; NSW Poisons Information Centre, The Children's Hospital at Westmead, Sydney, Australia., Gillooly I; The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, NSW, Australia., Patanwala AE; The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, NSW, Australia; Department of Pharmacy, Royal Prince Alfred Hospital, Camperdown, Sydney, Australia., Tan ECK; The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, NSW, Australia; Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Australia; Aging Research Centre, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden. Electronic address: edwin.tan@sydney.edu.au.
Jazyk: angličtina
Zdroj: Research in social & administrative pharmacy : RSAP [Res Social Adm Pharm] 2022 Jul; Vol. 18 (7), pp. 3184-3190. Date of Electronic Publication: 2021 Sep 14.
DOI: 10.1016/j.sapharm.2021.09.003
Abstrakt: Background: Adverse drug events (ADEs) remain a key contributor to hospitalisations, resulting in long hospital stays and readmissions. Information pertaining to the specific medications and clinical factors associated with these outcomes is limited. Hence, a better understanding of these factors and their relationship to ADEs is required.
Objectives: To investigate medications involved, clinical manifestations of ADE-related hospitalisations, and their association with length of stay and readmission.
Methods: A retrospective medical record review of patients admitted to a major, tertiary referral hospital in NSW, Australia, from January 2019 to August 2020 was conducted. ADEs were identified using Australian Refined Diagnosis Related Group (AR-DRG) codes: X40, X61, X62 and X64. Medications were classified per the Anatomical Therapeutic Chemical (ATC) classification system and clinical symptoms were classified per the International Classification of Disease (ICD) 9-CM. Logistic regression was performed to assess the relationship between medication and presentation classes with length of stay (≥2 days vs <2 days) and readmission.
Results: There were 125 patients who met inclusion criteria (median age = 64 [interquartile range, 45-75] years; 53.6% male). Anti-thrombotic agents, opioids, antidepressants, antipsychotics, insulins and NSAIDs were the most implicated pharmacological classes. Neurological medications and falls were associated with a length of stay ≥2 days (adjusted odds ratio [aOR] 3.92, 95% confidence interval [CI] 1.48-10.33 and aOR 3.24, 95% CI 1.05-10.06, respectively). Neurological medications and neurological and cognitive disorders were associated with an increased likelihood of 90-day readmission (aOR 2.63, 95% CI 1.05-6.57 and aOR 3.20, 95% CI 1.17-8.75, respectively).
Conclusion: This study identified neurological medications as high-risk for increased length of stay and readmission in those hospitalised due to ADEs. This highlights the need for judicious prescribing and monitoring of these medications.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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