Clinical Analysis and Economic Evaluation of 63 Cases of Nosocomial Drug-induced Liver Injury / 中国药房

ABSTRACT

OBJECTIVE:To provide reference for prevention of nosocomial drug-induced liver injury(DILI),early diagnosis of DILI and appropriate disposal of DILI.METHODS:4 975 medical records were randomly collected from a grade three class A hospital during 2008～2009.The incidence of DILI,hospitalization costs,extended time of hospital stay and prevention of DILI were analyzed retrospectively and economic evaluation was carried out.RESULTS:DILI occurred in 63 cases with the incidence rate of 1.27%.Among these cases,10 cases(15.87%) were preventable.For each DILI,average increased medical cost was 3 220.26 yuan and average extended time of hospital stay was 4.38 d.For the preventable DILI,the average increased medical cost was 6 239.85 yuan,and average extended time of stay was 8.30 d.The top 3 drugs which caused liver injury were anti-infective drugs(including antitubercular agent,41.27%),antineoplastic agents(28.57%) and cardiovascular drugs(7.94%).Types of DILI were as follows:live cell injury accounted for 65.08%,cholestasis accounted for 25.40%,and mixed type accounted for 9.52%.CONCLUSION:DILI is characterized with high incidence rate among patients and high medical cost.Some of DILI cases are preventable.Therefore,There is advantage both in clinical and economic aspects to reduce the incidence rate of preventable DILI by emphasizing rational use of drugs.