Giám sát tích cực biến cố xuất huyết của thuốc chống đông thông qua bộ công cụ phát hiện tín hiệu (IHI GTT 2009) tại chuyên khoa tim mạch của một bệnh viện tuyến trung ương

Abstract

USING THE IHI GTT 2009 TOOLKIT AT THE CARDIOVASCULAR DEPARTMENT OF A TERTIARY HOSPITAL

Objectives: To identify bleeding events associated with anticoagulants using the IHI GTT 2009 toolkit at the Cardiovascular Institute - Bach Mai Hospital, and to analyze the characteristics and preventability of these events.

Methods: This retrospective cross-sectional study was conducted using inpatient medical records with admission dates from April 1 to September 30, 2023, at the Cardiovascular Institute, Bach Mai Hospital. Anticoagulant-associated bleeding events were identified using the modified IHI GTT 2009 toolkit.

Results: 410/2,827 medical records had positive signals, leading to the detection of 179 ADEs in 129 patients (153 ADEs appeared before hospital admission). The ADEs were diverse, affecting many different organ systems. ADEs per 100 hospital admissions was 6,33; ADEs per 1.000 patient-days was 8,4. The IHI GTT 2009 toolkit had a positive predictive value (PPV) of 0,27. There were 148 ADEs classified at level F. A total of 147 ADEs had a causal relationship with drugs, and 47 preventable ADRs (pADRs) accounted for 32%. The most common causes of pADRs were inappropriate prescribing for the disease condition, drug interactions and patient non-compliance with treatment.

Conclusion: The modified IHI GTT 2009 toolkit enabled systematic detection of anticoagulant-related bleeding ADEs, identifying a substantially higher number of events compared to spontaneous ADR reports from the same unit in the preceding period. The study also identified common causes of preventable adverse drug reactions (pADR), thereby guiding professional interventions aimed at minimizing the risk of anticoagulant-related bleeding.