Development of an Adverse Drug Reaction Risk Assessment Score among Hospitalized Patients with Chronic Kidney Disease

被引:31
作者
Sharif-Askari, Fatemeh Saheb [1 ]
Sulaiman, Syed Azhar Syed [1 ]
Sharif-Askari, Narjes Saheb [1 ]
Hussain, Ali Al Sayed [2 ]
机构
[1] Univ Sains Malaysia, Sch Pharmaceut Sci, Discipline Clin Pharm, George Town, Malaysia
[2] Dubai Hlth Author, Dept Pharm, Dubai, U Arab Emirates
关键词
GLOMERULAR-FILTRATION-RATE; ELDERLY-PATIENTS; CLINICAL-TRIALS; EVENTS; ASSOCIATION; VALIDATION; FAILURE; MODELS;
D O I
10.1371/journal.pone.0095991
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background: Adverse drug reactions (ADRs) represent a major burden on the healthcare system. Chronic kidney disease (CKD) patients are particularly vulnerable to ADRs because they are usually on multiple drug regimens, have multiple comorbidities, and because of alteration in their pharmacokinetics and pharmacodynamic parameters. Therefore, one step towards reducing this burden is to identify patients who are at increased risk of an ADR. Objective: To develop a method of identifying CKD patients who are at increased risk for experiencing ADRs during hospitalisation. Materials and Methods: Factors associated with ADRs were identified by using demographic, clinical and laboratory variables of patients with CKD stages 3 to 5 (estimated glomerular filtration rate, 10-59 ml/min/1.73 m(2)) who were admitted between January 1, 2012, and December 31, 2012, to the renal unit of Dubai Hospital. An ADR risk score was developed by constructing a series of logistic regression models. The overall model performance for sequential models was evaluated using Akaike Information Criterion for goodness of fit. Odd ratios of the variables retained in the best model were used to compute the risk scores. Results: Of 512 patients (mean [SD] age, 60 [16] years), 62 (12.1%) experienced an ADR during their hospitalisation. An ADR risk score included age 65 years or more, female sex, conservatively managed end-stage renal disease, vascular disease, serum level of C-reactive protein more than 10 mg/L, serum level of albumin less than 3.5 g/dL, and the use of 8 medications or more during hospitalization. The C statistic, which assesses the ability of the risk score to predict ADRs, was 0.838; 95% CI, 0.784-0.892). Conclusion: A score using routinely available patient data can be used to identify CKD patients who are at increased risk of ADRs.
引用
收藏
页数:8
相关论文
共 40 条
[1]  
[Anonymous], BRIT NATL FORMULARY
[2]  
[Anonymous], 1993, An introduction to the bootstrap
[3]  
[Anonymous], 2004, INT CLASSIFICATION D, V10th
[4]   The TIMI risk score for unstable angina/non-ST elevation MI - A method for prognostication and therapeutic decision making [J].
Antman, EM ;
Cohen, M ;
Bernink, PJLM ;
McCabe, CH ;
Horacek, T ;
Papuchis, G ;
Mautner, B ;
Corbalan, R ;
Radley, D ;
Braunwald, E .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2000, 284 (07) :835-842
[5]   Patient risk factors for adverse drug events in hospitalized patients [J].
Bates, DW ;
Miller, EB ;
Cullen, DJ ;
Burdick, L ;
Williams, L ;
Laird, N ;
Petersen, LA ;
Small, SD ;
Sweitzer, BJ ;
Vander Vliet, M ;
Leape, LL .
ARCHIVES OF INTERNAL MEDICINE, 1999, 159 (21) :2553-2560
[6]   Heart Failure and Adverse Drug Reactions Among Hospitalized Older Adults [J].
Catananti, C. ;
Liperoti, R. ;
Settanni, S. ;
Lattanzio, F. ;
Bernabei, R. ;
Fialova, D. ;
Landi, F. ;
Onder, G. .
CLINICAL PHARMACOLOGY & THERAPEUTICS, 2009, 86 (03) :307-310
[7]   The exclusion of patients with chronic kidney disease from clinical trials in coronary artery disease [J].
Charytan, D. ;
Kuntz, R. E. .
KIDNEY INTERNATIONAL, 2006, 70 (11) :2021-2030
[8]   Concealed renal insufficiency and adverse drug reactions in elderly hospitalized patients [J].
Corsonello, A ;
Pedone, C ;
Corica, F ;
Mussi, C ;
Carbonin, P ;
Incalzi, RA .
ARCHIVES OF INTERNAL MEDICINE, 2005, 165 (07) :790-795
[9]   Concealed renal failure and adverse drug reactions in older patients with type 2 diabetes mellitus [J].
Corsonello, A ;
Pedone, C ;
Corica, F ;
Mazzei, B ;
Di Iorio, A ;
Carbonin, P ;
Incalzi, RA .
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES, 2005, 60 (09) :1147-1151
[10]   Association between Glomerular Filtration Rate and Adverse Drug Reactions in Elderly Hospitalized Patients The Role of the Estimating Equation [J].
Corsonello, Andrea ;
Pedone, Claudio ;
Lattanzio, Fabrizia ;
Onder, Graziano ;
Incalzi, Raffaele Antonelli .
DRUGS & AGING, 2011, 28 (05) :379-390