216例死亡病例的不良反应回顾性分析

Retrospective analysis of untoward reaction in 216 dead cases

目的统计我院死亡病例中药物不良反应(ADR)发生情况及相关因素。方法对解放军第411医院2007年1—8月收集的216例死亡患者的用药情况进行汇总分析。结果用药种类42 484种,药物不良反应为3 270例次,发生率为7.6%。肯定的为1 478例占45.1%,发生率为3.5%;可能的为1 292例占39.5%,发生率为3.0%;可疑的为500例占15.2%,发生率为1.2%。在年龄、性别、住院时间、医嘱数、APACHE3评分系统与不良反应的关系中,82岁≤年龄<83岁,0<医嘱数<5,25≤评分<28,30 d<住院时间<60 d与总严重的不良反应率间存在一定的相关性。医嘱数与总的不良反应和严重的不良反应具有一定的线性关系,总的不良反应与医嘱数有25.3%的相关性;严重的不良反应与医嘱数有19.7%的相关性。结论死亡患者用药发生ADR的次数与医嘱、年龄、评分、住院时间相关,其中以医嘱影响尤为重要,应审慎用药,以减少或避免ADR的发生。

Objective It is to investigate the occurrence status and correlative factors of adverse drug reactions（ADR） in dead cases in our hospital.Methods The medication status of 216 dead cases in the 411st hospital of PLA from January 2007 to August 2007 were collected and analyzed.Results There were 3 270 ADRs in 42 484 medicine total count and the incidence rate was 7.6%.Of those,1 478 cases（45.1%） was positive and the incidence rate was 3.5%,1 292 cases（39.5%） was probable and the incidence rate was 3.0% and 500 cases（15.2%） was dubitable and the incidence rate was 1.2%.In the correlation between ADR and the related factors such as age,sex,length of stay,medical order number and APACHE3 score system,82 years old≤age83 years old,0 medical order number5,25 ≤score28 and 30 dlength of stay60 d had determinate correlation with the incidence rate of serious ADR.Medical order number had determinate linear relationship with total ADR and serious ADR.Total ADR had 25.3% correlation with medical order number.Serious ADR had 19.7% correlation with medical order number.Conclusion ADR of dead cases has correlation with medical order,age,score and length of stay,especially medical order.Medication should be scrupulosity so as to decrease and avoid the occurrence of ADR.