Occurrence of Antithrombotic Related Adverse Events in Hospitalized Patients: Incidence and Clinical Context between 2008 and 2016
Autor: | Martine C. de Bruijne, C. Wagner, Menno V. Huisman, M. J. Moesker, Peter Spreeuwenberg, Bernadette C F M Schutijser, Janke Frederike de Groot, Maaike Langelaan |
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Přispěvatelé: | Public and occupational health, APH - Methodology, APH - Quality of Care, APH - Digital Health |
Jazyk: | angličtina |
Rok vydání: | 2019 |
Předmět: |
medicine.medical_specialty
anticoagulants Hospitalized patients lcsh:Medicine Context (language use) 030204 cardiovascular system & hematology Article 03 medical and health sciences 0302 clinical medicine INR self-monitoring Internal medicine Antithrombotic epidemiological studies medicine antithrombotic drugs 030212 general & internal medicine Adverse effect business.industry Incidence (epidemiology) lcsh:R General Medicine medication safety Confidence interval carbohydrates (lipids) Oral anticoagulant business |
Zdroj: | Journal of Clinical Medicine, 8(6) Journal of Clinical Medicine, Vol 8, Iss 6, p 839 (2019) Journal of Clinical Medicine, 8(6). MDPI Moesker, M J, Schutijser, B C F M, de Groot, J F, Langelaan, M, Spreeuwenberg, P, Huisman, M V, de Bruijne, M C & Wagner, C 2019, ' Occurrence of Antithrombotic Related Adverse Events in Hospitalized Patients : Incidence and Clinical Context between 2008 and 2016 ', Journal of Clinical Medicine, vol. 8, no. 6 . https://doi.org/10.3390/jcm8060839 Journal of Clinical Medicine Volume 8 Issue 6 |
ISSN: | 2077-0383 |
Popis: | Antithrombotic drugs are consistently involved in medication-related adverse events (MRAEs) in hospitalized patients. We aimed to estimate the antithrombotic-related adverse event (ARAE) incidence between 2008 and 2016 and analyse their clinical context in hospitalized patients in The Netherlands. A post-hoc analysis of three national studies, aimed at adverse event (AE) identification, was performed. Previously identified AEs were screened for antithrombotic involvement. Crude and multi-level, case-mix adjusted ARAE and MRAE incidences were calculated. Various contextual ARAE characteristics were analysed. ARAE incidence between 2008 and 2016 decreased significantly in in-hospital deceased patients from 1.20% (95% confidence interval (CI): 0.63&ndash 2.27%) in 2008 to 0.54% (95% CI: 0.27&ndash 1.11%) in 2015/2016 (p = 0.02). In discharged patients ARAE incidence remained stable. By comparison, overall MRAE incidence remained stable for both deceased and discharged patients. Most ARAEs involved Vitamin-K antagonists (VKAs). Preventable ARAEs occurred more during weekends and with increasing multidisciplinary involvement. Antiplatelet and combined antithrombotic use seemed to be increasingly involved in ARAEs over time. ARAE incidence declined by 55% in deceased patients between 2008 and 2016. Opportunities for improving antithrombotic safety should target INR monitoring and care delivery aspects such as multidisciplinary involvement and weekend care. Future ARAE monitoring for the involvement of antiplatelet, combined antithrombotic and direct oral anticoagulant (DOAC) use is recommended. |
Databáze: | OpenAIRE |
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