改善急性住院期间药物审查的患者分层方法
Louise Westberg Strejby Christensen1,2,3, Helle Gybel Juul-Larsen1, Line Jee Hartmann Rasmussen1,4
1Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark.
确定高风险患者进行医院药物检查至关重要. 虚弱指数 (FI-OutRef) 或suPAR水平比传统方法更好地预测不良结果,改善患者对药物审查的选择.
科学领域:
- 临床药房
- 老年医学
- 内部医学
背景情况:
- 医院药物审查发现不合适的处方,但资源限制需要有针对性的患者选择.
- 目前的患者分层依赖于药物数量和年龄, 可能缺少高危人群.
- 预测重新接收或死亡等不良临床结果是有效的药物评估目标的关键.
研究的目的:
- 探索药物数量和年龄以外的临床因素是否可以改善急性住院医疗患者的不良临床结果的预测.
- 确定新的生物标志物或指数,以便更好地对患者进行药物评估.
主要方法:
- 一项探索性研究分析了哥本哈根Hvidovre大学医院的27873名急性住院患者 (≥18岁) 的数据.
- 评估结果是急性再入院或退院后90天内死亡.
- 预测模型将传统因素 (药物数量,年龄) 与药物风险评分 (MERIS),功能,抗胆固醇负担,脆弱指数 (FI-OutRef) 和可溶性尿素酶等离子体激活受体 (suPAR) 进行比较.
主要成果:
- 与药物数量和年龄相比,MERIS,功能和抗胆固醇负担都没有改善结果的预测.
- 纳入虚弱指数 (FI-OutRef) 或suPAR显著提高了90天不良临床结果的预测.
- 这些发现表明FI-OutRef和suPAR对于识别药物评估最有利的患者是有价值的.
结论:
- 与传统因素相比,虚弱指数 (FI-OutRef) 和suPAR是住院患者不良临床结果的优势预测指标.
- 这些生物标志物为改善药物评估患者分层提供了疾病负担的实际代理.
- 优化药物审查目标可以提高医院的患者安全和资源分配.
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