scholarly journals Gastrointestinal Adverse Events in Hospitalized Patients Following Orthopedic Surgery: Tapentadol Immediate Release Versus Oxycodone Immediate Release

2021 ◽  
pp. E309-E315
Author(s):  
Asad E. Patanwala
Keyword(s):  
Postoperative Pain ◽  
Electronic Medical Records ◽  
Orthopedic Surgery ◽  
Medical Records ◽  
Adverse Drug Events ◽  
Immediate Release ◽  
Orthopedic Procedures ◽  
Study Cohort ◽  
Tertiary Referral Hospital ◽  
Significant Difference

Background: Tapentadol has relatively less effect on μ-opioid receptors compared with other opioids. This has the potential to reduce the occurrence of gastrointestinal (GI) adverse drug events (ADEs). Objectives: To compare the GI ADEs during hospitalization between tapentadol immediate release (IR) and oxycodone IR following orthopedic surgeries. Study Design: Retrospective cohort study. Setting: A major metropolitan tertiary referral hospital in Australia. Methods: Data for adult orthopedic surgery patients receiving postoperative tapentadol IR or oxycodone IR during hospitalization between January 1, 2018 and June 30, 2019, were collected from electronic medical records. The primary outcome was the occurrence of postoperative GI ADEs occurring during hospitalization. This was defined as a composite of nausea, vomiting, or constipation. Results: The study cohort included 199 patients. Of these, 99 patients received tapentadol IR and 100 patients received oxycodone IR for postoperative pain during hospitalization. The mean age was 66 ± 12 years, and 111 patients (56%) were women. There was no significant difference between groups on the occurrence of GI ADEs (53% in oxycodone group and 51% in tapentadol group, difference 2%, 95% confidence interval [CI], –11% to 16%; P = 0.777). After adjusting for potential confounders, the use of tapentadol IR was not associated with a significant reduction of GI ADEs (odds ratio, 0.62; 95% CI, 0.32–1.20; P = 0.154). Limitations: This was a single-center study and should be extrapolated with caution. As this was a retrospective study, the accuracy and availability of data were dependent on documentation in electronic medical records. Conclusions: Tapentadol IR is associated with similar GI ADE occurrence compared with oxycodone IR in patients with orthopedic postoperative pain during hospitalization. Key words: Opioid analgesics, tapentadol, oxycodone, orthopedic procedures, postoperative pain, acute pain, gastrointestinal adverse drug events, opioid-induced adverse drug events

scholarly journals Reducing error in anticoagulant dosing via multidisciplinary team rounding at point of care

2017 ◽  
Vol 7 (2) ◽  
Author(s):  
Munish Sharma ◽  
Mahesh Krishnamurthy ◽  
Richard Snyder ◽  
James Mauro
Keyword(s):  
Renal Function ◽  
Patient Safety ◽  
Electronic Medical Records ◽  
Clinical Pharmacist ◽  
Medical Records ◽  
Therapeutic Response ◽  
Adverse Drug Events ◽  
Point Of Care ◽  
Bleeding Diathesis ◽  
Dosage Error

The incorporation of a clinical pharmacist in daily rounding can help identify and correct errors related to anticoagulation dosing. Inappropriate anticoagulant dosing increases the risk of developing significant bleeding diathesis. Conversely, inappropriate dosing may also fail to produce a therapeutic response. We retrospectively reviewed electronic medical records of 41 patients to confirm and analyze the errors related to various anticoagulants. A clinical pharmacist in an integrated rounding between the period of February 2016 and April 2016 collected this data. We concluded that integrated rounding improves patient safety by recognizing anticoagulant dosage error used for the purpose of prophylaxis or treatment. It also allows us to make dose adjustments based on renal function of the patient. We think that it is prudent for physicians to pay particular attention to creatinine clearance when dosing anticoagulants in order to achieve the intended dosing effect and reduce the risk of adverse drug events.

scholarly journals A method for systematic discovery of adverse drug events from clinical notes

2015 ◽  
Vol 22 (6) ◽  
pp. 1196-1204 ◽  
Author(s):  
Guan Wang ◽  
Kenneth Jung ◽  
Rainer Winnenburg ◽  
Nigam H Shah
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Adverse Drug Events ◽  
Area Under The Curve ◽  
Data Sources ◽  
Clinical Notes ◽  
Post Marketing Surveillance ◽  
Post Marketing ◽  
Harmful Effects ◽  
Positive Support

Abstract Objective Adverse drug events (ADEs) are undesired harmful effects resulting from use of a medication, and occur in 30% of hospitalized patients. The authors have developed a data-mining method for systematic, automated detection of ADEs from electronic medical records. Materials and Methods This method uses the text from 9.5 million clinical notes, along with prior knowledge of drug usages and known ADEs, as inputs. These inputs are further processed into statistics used by a discriminative classifier which outputs the probability that a given drug–disorder pair represents a valid ADE association. Putative ADEs identified by the classifier are further filtered for positive support in 2 independent, complementary data sources. The authors evaluate this method by assessing support for the predictions in other curated data sources, including a manually curated, time-indexed reference standard of label change events. Results This method uses a classifier that achieves an area under the curve of 0.94 on a held out test set. The classifier is used on 2 362 950 possible drug–disorder pairs comprised of 1602 unique drugs and 1475 unique disorders for which we had data, resulting in 240 high-confidence, well-supported drug-AE associations. Eighty-seven of them (36%) are supported in at least one of the resources that have information that was not available to the classifier. Conclusion This method demonstrates the feasibility of systematic post-marketing surveillance for ADEs using electronic medical records, a key component of the learning healthcare system.

scholarly journals Renal Replacement Therapy and Concurrent Fluconazole Therapy Increase Linezolid-Related Thrombocytopenia Among Adult Patients

2021 ◽  
Author(s):  
Yueh-Chun Hsu ◽  
Szu-Ying Chen ◽  
Yung-Jun Hung ◽  
Yu-Wei Huang
Keyword(s):  
Risk Factors ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Retrospective Cohort ◽  
Binary Logistic Regression ◽  
Limited Information ◽  
Significant Difference ◽  
Fluconazole Therapy

Abstract Linezolid has been reported to be associated with thrombocytopenia. However, limited information is available on susceptibility to thrombocytopenia after linezolid usage. We aimed to investigate the risk factors for linezolid-associated thrombocytopenia (LAT). We conducted a retrospective cohort study of patients aged ≥ 18 years who received linezolid for ≥ 5 d during hospitalization in 2019. Information was extracted from electronic medical records. Thrombocytopenia was defined as a platelet count of < 100×109/L or a reduction from baseline ≥ 25%. Binary logistic regression and survival analyses were used to evaluate the risk factors for LAT. A total of 98 patients were enrolled. Thrombocytopenia occurred in 53.1% patients, with a median of 9 d after initiation of linezolid. There was no significant difference in the mortality or proportion of platelet transfusions between patients with and without thrombocytopenia. A higher risk of LAT was found in patients who received renal replacement therapy (RRT) (OR 4.8 [1.4–16.4]), concurrent fluconazole (OR 3.5 [1.2–9.8]), or a longer duration of linezolid treatment (OR 1.1 [1.0-1.1]). Patients who received RRT (8 vs. 15 d) or concurrent fluconazole (11 vs. 15 d) had a shorter median time to develop thrombocytopenia. Those who simultaneously received RRT and fluconazole had the shortest median of time (6.5 d) and the highest risk of developing thrombocytopenia (87.5%).

scholarly journals Ongoing Use of SSRIs Does Not Alter Outcome in Hospitalized COVID-19 Patients: A Retrospective Analysis

2021 ◽  
Vol 11 (1) ◽  
pp. 70
Author(s):  
Steven H. Rauchman ◽  
Sherri G. Mendelson ◽  
Courtney Rauchman ◽  
Lora J. Kasselman ◽  
Aaron Pinkhasov ◽  
...  
Keyword(s):  
Electronic Medical Records ◽  
Symptom Severity ◽  
Medical Records ◽  
Logistic Regression Model ◽  
Clinical Information ◽  
Infectious Agents ◽  
Clinical Databases ◽  
Significant Difference ◽  
Ssri Treatment ◽  
Age Category

SARS-CoV-2 continues to have devastating consequences worldwide. Though vaccinations have helped reduce spread, new strains still pose a threat. Therefore, it is imperative to identify treatments that prevent severe COVID-19 infection. Recently, acute use of SSRI antidepressants in COVID+ patients was shown to reduce symptom severity. The aim of this retrospective observational study was to determine whether COVID+ patients already on SSRIs upon hospital admission had reduced mortality compared to COVID+ patients not on chronic SSRI treatment. Electronic medical records of 9044 patients with laboratory-confirmed COVID-19 from six hospitals were queried for demographic and clinical information. Using R, a logistic regression model was run with mortality as the outcome and SSRI status as the exposure. In this sample, no patients admitted on SSRIs had them discontinued. There was no significant difference in the odds of dying between COVID+ patients on chronic SSRIs vs. those not taking SSRIs, after controlling for age category, gender, and race. This study shows the utility of large clinical databases in determining what commonly prescribed drugs might be useful in treating COVID-19. During pandemics due to novel infectious agents, it is critical to evaluate safety and efficacy of drugs that might be repurposed for treatment.

scholarly journals Nonadherence to follow-up recommendations is common for dogs and cats undergoing orthopedic surgery

2021 ◽  
Vol 260 (S1) ◽  
pp. S83-S87
Author(s):  
Kevin A. de Moya ◽  
Jade M. Reppenhagen ◽  
Stanley E. Kim
Keyword(s):  
Body Weight ◽  
Financial Aid ◽  
Orthopedic Surgery ◽  
Medical Records ◽  
Clinical Relevance ◽  
Orthopedic Procedures ◽  
Factors Associated ◽  
Procedure Cost ◽  
Lost To Follow Up

Abstract OBJECTIVE To evaluate owner adherence to recommendations for follow-up examination of dogs and cats following orthopedic procedures and identify factors associated with adherence versus nonadherence. SAMPLE Medical records of 485 dogs and cats that underwent orthopedic surgery. PROCEDURES Cases were categorized as urgent or elective. Information obtained from the medical records consisted of species, age, body weight, proximity to the hospital, procedure cost, recommendations for coaptation, use of financial aid, and number of owners. Cases were considered adherent to follow-up recommendations if, at the latest visit or communication, no further visits were recommended. Cases were considered nonadherent if owners did not return for recommended follow-up visits. RESULTS Overall adherence to follow-up recommendations was 65.8% (319/485). Elective cases were 1.6 times as likely to be adherent to follow-up recommendations as were urgent cases, dog cases were 2.4 times as likely to be adherent as were cat cases, and cases with multiple owners listed were 2.1 times as likely to be adherent as were cases with 1 owner listed. Distance from the hospital had a statistically significant association with adherence, but the effect was not clinically important. Age, weight, coaptation, procedure cost, and use of financial aid were not significantly associated with adherence. CONCLUSIONS AND CLINICAL RELEVANCE The percentage of dogs and cats lost to follow-up following orthopedic surgery at an academic veterinary teaching hospital was substantial (166/485 [34.2%]). Efforts to improve follow-up adherence are especially indicated for animals undergoing urgent procedures, animals with single owners, and cats.

Towards Human–Machine Collaboration in Creating an Evaluation Corpus for Adverse Drug Events in Discharge Summaries of Electronic Medical Records

2016 ◽  
Vol 4 ◽  
pp. 37-43 ◽  
Author(s):  
Pei San Ang ◽  
Liza Y.P. Fan ◽  
Mun Yee Tham ◽  
Siew Har Tan ◽  
Sally B.L. Soh ◽  
...  
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Adverse Drug Events ◽  
Discharge Summaries

Use of electronic medical records to detect adverse drug events and medication errors in outpatients.

2003 ◽  
Vol 73 (2) ◽  
pp. P96-P96
Author(s):  
C. J. Hope ◽  
A. C. Seger ◽  
J. M. Overhage ◽  
T. K. Gandhi ◽  
E. Y. Teal ◽  
...  
Keyword(s):  
Electronic Medical Records ◽  
Medication Errors ◽  
Medical Records ◽  
Adverse Drug Events

scholarly journals Predicting Adverse Drug Events from Electronic Medical Records

2015 ◽  
pp. 243-257
Author(s):  
Jesse Davis ◽  
Vítor Santos Costa ◽  
Peggy Peissig ◽  
Michael Caldwell ◽  
David Page
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Adverse Drug Events
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