在重症患者中使用与QTc延长相关的药物的患病率
Ahmad Al-Azayzih1, Walid Al-Qerem2, Sayer Al-Azzam1
1Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.
Vascular health and risk management
|February 6, 2024
概括
危急病患者经常接受延长修正的QT (QTc) 间隔的药物,增加Torsade de Pointes (TdP) 风险. 在ICU中的多种药物显著增加了这种风险,需要谨慎的处方.
科学领域:
- 临床医学 临床医学
- 药理学 药理学是指药理学的学科.
- 关键的护理关键的护理
背景情况:
- 获得的长时间纠正的QT (QTc) 间隔是危及生命的Torsade de Pointes (TdP) 心律失常的危险因素.
- 危急病患者因复杂的病情,衰老和多药性而面临TdP的高度脆弱性.
研究的目的:
- 评估约旦危急病患者中TdP相关药物处方的流行情况.
- 确定QTc延长和TdP的危险因素.
- 为了确定这个人群中高TdP药物使用的预测因素.
主要方法:
- 对13300份阿卜杜拉国王大学医院重症监护室电子病历 (2012年7月至2022年7月) 的回顾性横截面分析.
- 根据TdP风险分类的药物使用CredibleMeds®工具.
- 二元物流回归用于识别风险因素和预测因素.
主要成果:
- 19%的患者接受了已知TdP风险的药物;与TdP相关的药物处方的总体流行率是显著的.
- 常见的并发病包括高血压,糖尿病和癌症.
- 增加的年龄与降低TdP药物处方几率相关 (OR=0.989),而多药 (≥5种药物) 增加了几率 (OR=4.281).
结论:
- 在重症患者中,QTc延长/TdP风险药物处方的显著流行存在.
- 医疗保健提供者必须小心尽量减少与TdP相关的药物处方,特别是在老年患者和多药患者中.
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