Clinical factors associated with increased length of stay and readmission in patients with medication-related hospital admissions: a retrospective study
| Autor: | Rose Cairns, Edwin C.K. Tan, Isabelle Sarah Gillooly, Asad E. Patanwala, Ilsa R. Wojt |
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| Rok vydání: | 2022 |
| Předmět: |
Male
medicine.medical_specialty Drug-Related Side Effects and Adverse Reactions Pharmaceutical Science Pharmacy Logistic regression Tertiary referral hospital Patient Readmission Tertiary Care Centers Interquartile range medicine Humans Retrospective Studies business.industry Medical record Australia Retrospective cohort study Diagnosis-related group Odds ratio Length of Stay Middle Aged Confidence interval Hospitalization Emergency medicine Female business |
| Zdroj: | Research in Social and Administrative Pharmacy. 18:3184-3190 |
| ISSN: | 1551-7411 |
| Popis: | 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 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. |
| Databáze: | OpenAIRE |
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