scholarly journals Potential drug-drug interactions among elderly in-patients with cardiac illness at a tertiary care centre

2020 ◽  
Vol 9 (3) ◽  
pp. 470
Author(s):  
Akanksha Mathur ◽  
Nidhi Jain ◽  
Achal Sharma ◽  
Prashant C. Shah
Keyword(s):  
Risk Factors ◽  
Drug Interactions ◽  
Hospital Stay ◽  
Pearson Correlation ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Hospitalized Patients ◽  
Close Monitoring ◽  
Potential Drug ◽  
Cardiac Illness

Background: Drug interactions are major cause of concern in hospitalized patients with cardiac illness especially in elderly population. Therefore, the study was conducted to determine the prevalence and pattern of potential drug-drug interactions (pDDI) and risk factors, if any.Methods: It was a prospective observational study involving 75 elderly in-patients with cardiac diseases. IHEC approval was taken before commencement of study and written informed consent was taken from all the study participants. Data was collected using structured data collection tool. pDDI were analyzed using MEDSCAPE databse. Data was analyzed using SPSS 20.0 in terms of descriptive statistics. Pearson correlation coefficient was used to find the association between the risk factors and potential DDIs. P value of ≤0.05 was considered statistically significant.Results: The prevalence of pDDI was found to be 100%. Total 593 pDDI and 33 interacting drug pairs were observed in the study. The common drug interacting pairs were aspirin and furosemide 140 (23.61%), followed by aspirin+ enalapril 98 (16.53%) and heparin and clopidogrel 56 (9.44%). Majority of pDDI 480 (81%) were found to be of moderate severity. A significant association was documented between length of hospital stay (p=0.041) and occurrence of pDDI. A statistically significant correlation (r =0.621; p<0.01) was noted between number of drugs prescribed and total number of pDDIs.Conclusions: A high prevalence of pDDI was observed. The prevalence rate is directly related to number of drugs prescribed and length of hospital stay. Therefore, close monitoring of hospitalized patients is recommended.

scholarly journals ASSESSMENT OF POTENTIAL DRUG INTERACTIONS AMONG HOSPITALIZED PATIENTS IN NEUROLOGY DEPARTMENT IN TERTIARY CARE HOSPITALS

2019 ◽  
pp. 173-176
Author(s):  
DIJO DAIS ◽  
RANJEET AVIS CHERUVATHOOR ◽  
KAMESWARAN R ◽  
SHANMUGA SUNDARAM RAJAGOPAL
Keyword(s):  
Risk Factors ◽  
Drug Interactions ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Daily Basis ◽  
Potential Drug ◽  
Potential Ddis ◽  
Patient History ◽  
Therapeutic Advantage ◽  
Tertiary Care Hospitals

Objective: This research was instigated to determine and assess the prevalence, severity, type, and the total number of potential drug interactions in the neurology department of two hospitals in India. Methods: The data were collected from the prescriptions and by patient history interview on a daily basis. The drug-drug interactions (DDIs) were identified using Micromedex® database-2.7 and drugs.com. Results: The drug interactions were influenced by a plethora of risk factors: Gender, age, comorbidities, length of hospital stay, and the neurological condition. The study was comprised 320 patients, among 196 patients were identified with potential DDIs (PDDIs), and a total of 450 PDDIs were observed. The prevalence of PDDIs according to the severity was major (42.6%), moderate (45.11%), and minor (12.22%). Conclusion: To lessen PDDIs, the range of medications for the patients must be properly managed, and it is encouraged to remove all medicines without therapeutic advantage, intention, and an indication.

scholarly journals A Hospital based cross sectional study to find out factors associated with disease severity and length of hospital stay in COVID-19 patients in Tertiary Care Hospital of Ahmedabad city

2021 ◽  
Vol 33 (2) ◽  
pp. 256-259
Author(s):  
Arpit Chelabhai Prajapati ◽  
Mansi Maulik Patel ◽  
Hardika Jamanadas Khanpara ◽  
Rujul Pankajbhai Shukla ◽  
Donald Shailendra Christian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Stay ◽  
Disease Severity ◽  
Tertiary Care Hospital ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Care Hospital ◽  
Factors Associated ◽  
High Dependency

Background: Tertiary hospital care may vary from isolation bed ward care to high dependency units (HDUs) with oxygen support to intensive care unit (ICU) where patients may be intubated for mechanical ventilation The major risk factors for severe disease are age more than 60 years and underlying diseases like diabetes, hypertension. COVID-19 patients present at varying levels of severity. Understanding how long patients hospitalized with COVID-19 remain in hospital is critical for planning. Objectives: 1. To determine risk factors associated with disease severity 2. To determine risk factors associated with length of hospital stay in COVID-19 patients 3. To study the disease outcome Material & Methods: This was retrospective record-based study of inpatients with COVID-19 at Tertiary Care Hospital of Ahmedabad City. All patients admitted at tertiary care hospital diagnosed with COVID-19 between April 2020 to June, 2020, were included in present study. Inclusion criteria were all COVID-19 patients admitted at tertiary care hospital during the duration of April 2020 to June 2020. Results: A total of 916 COVID-19 patients were included in the study. Out of 916 total admitted patients 526 (57.4%) were male. 174 (19%) patients having one or more comorbidities like diabetes, hypertension, tuberculosis, heart diseases etc. Total 769 discharged (83.9%), 115 deaths (12.6%) and 32 transferred to other COVID-19 hospital (3.5%) out of total 916 patients admitted during study period. Conclusion: Severity of disease and deaths were associated with age and comorbidities. COVID-19 patients with comorbidities have more deteriorating outcomes compared with patients without.

ASSESSMENT OF CLINICAL OUTCOME AND THEIR RISK FACTORS IN PATIENTS WITH STROKE

2021 ◽  
pp. 160-163
Author(s):  
Dhanya Mary Louis ◽  
Haripriya P. S. ◽  
Sujit Kumar Sah ◽  
Siddartha N Dhurappanavar
Keyword(s):  
Risk Factors ◽  
Clinical Outcome ◽  
Hospital Stay ◽  
Clinical Outcomes ◽  
Muscle Power ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Stroke Patients ◽  
Prescribing Pattern ◽  
Factors Affecting

Globally, stroke is the second leading cause of mortality and disability. In india, 619000 in 9.4 million deaths were due to stroke. There is paucity of information regarding the factors affecting clinical outcome in stroke patients. This study aims to assess the risk factors associated with clinical outcomes in patients with stroke. A prospective observational study was conducted in neurology unit of a tertiary care teaching hospital with a total of 80 patients over a period of six months. During the study period, the subjects were followed till discharge to assesss the prescribing pattern and clinical outcomes. The clinical outcomes were assessed using modied ranking scale (mRS), Glasgow coma scale (GCS) and muscle power grading scale (MRC). Among the study subjects, 48(60%) were male, 40(50%) were aged 60 years and above. Patients received an average of 10.38 drugs during hospital stay, in which 77 (96.25) were prescribed with atorvastatin and 35(43.75%) with heparin. A combination of aspirin-clopidogrel was received by 70(87.5%). Total of 49(61.25%) patients had a good clinical outcome at the time of discharge. Mortality rate during hospitalization was foud to be 5%. The study concludes that factors such as age of 60 years and above, family history, polypharmacy, co-morbidities and length of hospital stay contribute to a negative clinical outcome in stroke patients.

scholarly journals ASSESSMENT OF POTENTIAL DRUG INTERACTIONS AMONG HOSPITALIZED PATIENTS AT THE CARDIAC AND PULMONARY DEPARTMENTS IN TERTIARY CARE HOSPITALS

2018 ◽  
Vol 11 (5) ◽  
pp. 443
Author(s):  
Kameswaran Ramalingam ◽  
Shanmuga Sundaram Rajagopal ◽  
Krishnaveni Kandasamy ◽  
Karthikeyan Krishnan
Keyword(s):  
Drug Interactions ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Hospitalized Patients ◽  
Cardiac Patients ◽  
Detailed Knowledge ◽  
Potential Drug ◽  
Common Drug ◽  
Hospital Stays ◽  
Tertiary Care Hospitals

Objective: The aim of this study was to assess the potential drug interactions among hospitalized patients in cardiac and pulmonary wards in three tertiary care hospitals.Methods: A prospective, observational study was carried out for 12 months. A sample of 1150 patients were assessed for potential drug-drug interactions (pDDIs) using Micromedex®- 2.7 and Drugs.com.Results: A total of 1150 patients were analyzed, and it was found that 685 were cardiac and 465 were pulmonary patients. The study identified 524 (76.49%) cardiac patients and 345 (74.19%) pulmonary patients, with pDDIs higher in male cardiac (298 [56.87%]) and male pulmonary (199 [57.68%]) patients, compared to females. Incidences of pDDIs were found to be higher in the age group of 60–70 years in cardiac (193 [36.83%]) and pulmonary (146 [42.31%]) patients and incidences of interactions based on duration of 4–6 days’ hospital stays in cardiac were 380 (72.53%) and 215 (62.31%) in pulmonary patients, respectively. Moreover, 51.90% of cardiac patients and 56.52% of pulmonary patients were found to be prescribed with more number of drugs (cardiac 7 drugs and pulmonary 5–6 drugs) causing higher incidences of pDDIs. Some of the most common drug interacting pair was aspirin and clopidogrel combination observed in 245 cardiac patients, whereas in the pulmonary department, it was ranitidine-theophylline combination with a frequency of 195 pDDIs. Drug-food interactions were found with atorvastatin–citrus fruits in cardiac and theophylline–caffeine in pulmonary patients. The most common drug-disease interaction was found to be isosorbide dinitrate–myocardial infarction in cardiac and diazepam–COPD in pulmonary, respectively.Conclusion: Pharmacists must take responsibility in the monitoring of drug interactions and notifying the physician and patient about potential problems. With their detailed knowledge of drugs, pharmacists have the ability to relate unexpected symptoms experienced by patients to possible adverse effects of their drug therapy.

scholarly journals Hungry Bone Syndrome (HBS) in Patients Operated for Primary Hyperparathyroidism (PHPT): A Six-Year Experience

2018 ◽  
Vol 32 (2) ◽  
pp. 11-16
Author(s):  
Rhoda Zyra M. Padilla-Baraoidan ◽  
Maria Jocelyn Capuli-Isidro ◽  
Beinjerinck Ivan B. Cudal ◽  
Ayezl A. Embestro-Pontillas
Keyword(s):  
Risk Factors ◽  
Primary Hyperparathyroidism ◽  
Hospital Stay ◽  
Tertiary Care ◽  
Photon Emission ◽  
Length Of Hospital Stay ◽  
The Philippines ◽  
Emission Computed Tomography ◽  
Hungry Bone Syndrome ◽  
Hungry Bone

Objective:      To review cases of adult patients who develop Hungry Bone Syndrome (HBS) after parathyroidectomy for Primary Hyperparathyroidism (PHPT) in a tertiary care center in the Philippines and describe the clinical features, pre-operative preventive measures done, and risk factors for HBS. Methods: Study Design:            Retrospective case note review Setting:                       Tertiary Private Hospital Participants:              Chart review of adult Filipino patients who underwent parathyroidectomy for PHPT at Makati Medical Center from January 2011 to December 2016 was conducted and evaluated according to the inclusion and exclusion criteria. Medical information obtained included clinical parameters, biochemical results, operation performed, pathology, length of hospital stay and complications if with any. Results:          From among 20 adult Filipino patients (mean age 55 years; 13, 65% female) who underwent parathyroidectomy for PHPT, HBS was found in 7 (35%). Most common pre-operative symptoms of hypercalcemia were musculoskeletal complaints. To prevent HBS, all were hydrated prior to surgery, while some were given bisphosphonates and diuretics. The most common parathyroid gland imaging used for pre-procedure localization was Tc 99m Sestamibi scan with single photon emission computed tomography (SPECT) and 19 (95%) had parathyroid adenoma on post-operative histopathologic report. Among biochemical and clinical factors that may be risk factors for HBS, those with HBS had significantly lower pre-operative 25-hydroxyvitamin D, higher BUN, phosphate and alkaline phosphatase (ALP) than those without HBS. Of these, only ALP showed significant association with HBS (OR = 107.17, p = <0.0001). Length of hospital stay was longer among those with HBS, although not statistically significant. Conclusion:    Knowledge on post-parathyroidectomy HBS for PHPT may aid clinicians on pre-operative prevention and post-operative monitoring. Thirty-five percent (7) of our patients presented with HBS post-parathyroidectomy for PHPT from 2011 to 2016. An abnormal ALP level pre-operatively may be a risk factor in developing HBS post-parathyroidectomy for PHPT. Keywords: primary hyperparathyroidism, hungry bone syndrome, Philippines

Effect of Pressure Ulcers on Length of Hospital Stay

2005 ◽  
Vol 26 (3) ◽  
pp. 293-297 ◽  
Author(s):  
Nicholas Graves ◽  
Frances Birrell ◽  
Michael Whitby
Keyword(s):  
Length Of Stay ◽  
Hospital Stay ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Robust Regression ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Hospitalized Patients ◽  
Independent Effect ◽  
Effect Of Pressure

AbstractObjective:To identify the independent effect of pressure ulcers on excess length of stay and control for all observable factors that may also contribute to excess length of stay. Hospitalized patients who develop a pressure ulcer during their hospital stay are at a greater risk for increased length of stay as compared with patients who do not.Design:Cross-sectional, observational study.Setting:Tertiary-care referral and teaching hospital in Australia.Patients:Two thousand hospitalized patients 18 years and older who had a minimum stay in the hospital of 1 night and admission to selected clinical units.Methods:Two thousand participants were randomly selected from 4,500 patients enrolled in a prospective survey conducted between October 2002 and January 2003. Quantile median robust regression was used to assess risk factors for excess length of hospital stay.Results:Having a pressure ulcer resulted in a median excess length of stay of 4.31 days. Twenty other variables were statistically significant at the 5% level in the final model.Conclusions:Pressure ulcers make a significant independent contribution to excess length of hospitalization beyond what might be expected based on admission diagnosis. However, our estimates were substantially lower than those currently used to make predictions of the economic costs of pressure ulcers; existing estimates may overstate the true economic cost.

scholarly journals Potential drug-drug interactions and their risk factors in pediatric patients admitted to the emergency department of a tertiary care hospital in Mexico

PLoS ONE ◽  
2018 ◽  
Vol 13 (1) ◽  
pp. e0190882 ◽  
Author(s):  
Olga Morales-Ríos ◽  
Luis Jasso-Gutiérrez ◽  
Alfonso Reyes-López ◽  
Juan Garduño-Espinosa ◽  
Onofre Muñoz-Hernández
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Drug Interactions ◽  
Pediatric Patients ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Potential Drug

scholarly journals STUDY OF DRUG-DRUG INTERACTION IN THE INPATIENTS OF A TERTIARY CARE HOSPITAL AT CALICUT

2018 ◽  
Vol 11 (9) ◽  
pp. 162
Author(s):  
Greeshma K George ◽  
Siraj Sundaran ◽  
Ashar Ali Cp ◽  
Mubeena Km ◽  
Thansiya Ph ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Health Care Professionals ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Close Monitoring ◽  
Care Hospital ◽  
Potential Drug ◽  
High Prevalence ◽  
Medication Chart ◽  
Pharmacokinetic Drug

Objective: The study was conducted to monitor the potential drug-drug interactions in the prescriptions of inpatients in a tertiary care hospital based on the mechanism and severity.Methods: This prospective observational study was conducted by collecting the prescriptions containing two or more drugs. The interactions were checked using an interaction checker and were categorized into pharmacokinetic and pharmacodynamic interactions on the basis of mechanism of action and severity based on the risks or consequences of the interactions.Result: Among 150 randomly collected prescriptions, 123 (82%) prescriptions had 396 drug-drug interactions. The pharmacodynamic drug interactions (77.27%) were more common when compared to pharmacokinetic drug interactions (22.73%). There was high prevalence of drug-drug interactions among the patients above the age of 60 years (56.09%). The moderate drug-drug interactions (81.81%) were found to be more when compared to the major (10.61%) and minor (7.58%) interactions. The neurology department prescriptions were observed to have more number of drug-drug interactions (26.01%).Conclusion: A systematic approach and close monitoring of the medication chart is necessary to identify the potential drug-drug interactions. The clinicians and other health-care professionals at the study site require an awareness program in regard to identification and management of drug-drug interactions. Clinical pharmacist can play an important role in the monitoring and management of drug-drug interactions.

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