Previsão de ocorrência de reação adversa a medicamento em pacientes hospitalizados

• Ano de defesa: 2021
• Autor(a) principal: Lima, Sara Iasmin Vieira Cunha
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal do Rio Grande do Norte; Brasil; UFRN; PROGRAMA DE PÓS-GRADUAÇÃO EM CIÊNCIAS FARMACÊUTICAS
• Palavras-chave em Português: Reação adversa a medicamento; Fatores de risco; Farmacovigilância; Escore de risco
• Link de acesso: https://repositorio.ufrn.br/handle/123456789/32766

Introduction: Adverse drug reactions (ADR) have a significant incidence among hospitalized patients. An important step in reducing the incidence of adverse reactions would be to identify those patients who are at increased risk of developing an ADR from individual risk factors. Objective: Develop a tool to predict adverse drug reactions in hospitalized patients. Methodology: Observational, analytical, case-control study in a 1: 2 ratio of all patients admitted during the period from June 2016 to December 2017 at Hospital Universitário Onofre Lopes, Brazil. For the identification of the variables of the patients associated with the occurrence of ADR, the univariate analysis of each patient variable by conditional logistic regression was performed initially with the entire study population. For the multivariate analysis were included the variables that in univariate analysis showed a significant association with the occurrence of ADR at a level of significance <0.10. The statistical program Stata 12 was used. Results: The proportion of patients with one or more ADRs was 5.31% (95% CI 4.77-8.88%). The most common adverse reactions were hypoglycemia (25.4%) and hypotension (19.8%). After gradual conditional logistic regression 14 variables that were shown to be associated with the occurrence of ADR, including female gender (OR adjusted ORA) 1.50, previous history of ADR (ORA 2.05), heart rate ≥ 72 bpm (ORA 1 , 96), systolic blood pressure ≥148 mmHg (ORA 1.70), diastolic blood pressure <79 mmHg (ORA 1.96), diabetes mellitus (ORA 2.10), serum urea ≥ 67 mg / dL (ORA 1, 94), serum sodium ≥ 141 mmol / L (ORA 1.83), serum potassium ≥ 4.9 mmol / L (ORA 1.67), main diagnosis classified in ICD-10 chapter II - Neoplasms (ORA 2.90) , prescription of ≥ 3 drugs ATC class B (ORA 1.82), prescription of ATC drugs class R (ORA 1.89), prescription of intravenous drugs (aORA 1.44) and prescription of ≥ 6 oral drugs (ORA 1 , 52). Conclusion: A risk stratification instrument based on these 14 risk factors showed, in the internal validation, an area under the ROC curve of 0.73, a sensitivity of 61% and specificity of 73%.