Pharmacotherapy for Adverse Events Reduces the Length of Hospital Stay in Patients Admitted to Otolaryngology Ward: A Single Arm Intervention Study

Abstract

BackgroundTo determine whether adverse events extend the duration of hospitalization, and to evaluate the effectiveness of medical intervention in ameliorating adverse events and reducing the prolonged hospital stay associated with adverse events.MethodsA single arm intervention study was conducted from October 2012 to March 2014 in the otolaryngology ward of a 614-bed, university-affiliated hospital. Adverse events were monitored daily by physicians, pharmacists and nurses, and recorded in the electronic medical chart for each patient. Appropriate drug management of adverse events was performed by physicians in liaison with pharmacists. The Kaplan-Meier method was used to assess the length of hospitalization of patients who underwent medical intervention for adverse events.ResultsOf 571 patients admitted to the otolaryngology ward in a year, 219 patients (38.4%) experienced adverse events of grade ≥2. The duration of hospitalization was affected by the grade of adverse events, with a mean duration of hospital stay of 9.2, 17.2, 28.3 and 47.0 days for grades 0, 1, 2, and 3–4, respectively. Medical intervention lowered the incidence of grade ≥2 adverse events to 14.5%. The length of hospitalization was significantly shorter in patients who showed an improvement of adverse events after medical intervention than those who did not (26.4 days vs. 41.6 days, hazard ratio 1.687, 95% confidence interval: 1.260–2.259, P<0.001). A multivariate Cox proportional hazard analysis indicated that insomnia, constipation, nausea/vomiting, infection, non-cancer pain, oral mucositis, odynophagia and neutropenia were significant risk factors for prolongation of hospital stay.ConclusionPatients who experienced adverse events are at high risk of prolonged hospitalization. Medical intervention for adverse events was found to be effective in reducing the length of hospital stay associated with adverse events.

Relationship between number of drugs and duration of hospital stay in older patients with neuromuscular diseases

“…The incidence of ADR is an important cause of morbidity and mortality, and has considerable influence on the cost for medical management and hospitalization . However, the occurrence and severity of ADR varies among wards, patient populations and therapeutic strategies …”

“…2,4,5 However, the occurrence and severity of ADR varies among wards, patient populations and therapeutic strategies. [6][7][8] We previously reported that several adverse events, including microbial infection, oral mucositis, odynophagia, neutropenia, insomnia and constipation, were significant risks for prolongation of hospital stay in patients with head and neck cancer who were admitted to the otolaryngology ward. 8 Notably, pharmacotherapies for amelioration of such adverse events were effective in reducing the duration of hospital stay.…”

Oral mucosal injury caused by mammalian target of rapamycin inhibitors: emerging perspectives on pathobiology and impact on clinical practice

“…In contrast, a unique manifestation of oral mucosal injury has been documented within the past 5 years in association with mammalian target of rapamycin (mTOR) inhibitors 8, 9, 10. This latter toxicity has now emerged as one of the most common adverse events associated with targeted cancer therapies 11, 12, 13, 14, 15, 16, including in women being treated for invasive breast cancer 17, 18.…”

Effect of polaprezinc on oral mucositis, irradiation period, and time to discharge in patients with head and neck cancer

“…9 Moreover, subgroup analysis of the study of 121 patients who received radiotherapy for head and neck cancer indicated that pharmaceutical interventions to ameliorate the symptoms of such adverse events significantly reduce the hospitalization period. 9 Moreover, subgroup analysis of the study of 121 patients who received radiotherapy for head and neck cancer indicated that pharmaceutical interventions to ameliorate the symptoms of such adverse events significantly reduce the hospitalization period.…”

“…9 Notably, pharmacotherapies for the cure of such adverse events are effective in reducing the duration of hospital stay in patients with head and neck cancer. 9 Notably, pharmacotherapies for the cure of such adverse events are effective in reducing the duration of hospital stay in patients with head and neck cancer.…”