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Adverse drug events are a major cause of acute medical admission.
Intern Med J. 2014 Apr 21;
Authors: McLachlan CY, Yi M, Ling A, Jardine DL
Abstract
BACKGROUND: Adverse drug events (ADEs) contribute significantly to hospital admissions. Prospective New Zealand data is scant and the ability of clinical coding to identify ADE associated admissions is uncertain. Outcomes after cessation of causative medications are unknown.
AIMS: To assess the frequency, nature and causality of ADEs associated with acute admissions to General Medicine at Christchurch Hospital.
METHODS: Prospective observational study of patients admitted to our medical team over 20 weeks.
RESULTS: Of 336 admissions, 96 (28.6%) were ADE related. 65 (19.3%) were caused by an ADE and 31 (9.2%) were contributed to by an ADE. The mean age of non ADE patients was 64.3 years (range 16-91) which was similar to the mean age of ADE patients (65.9 years; 21-92). However if intentional overdoses and recreational drug use were excluded, ADE patients were significantly older at 72.4 years (21-92) (p=0.0007). ADE patients took more regular medications on admission (mean 6.6, range 0-22) than non ADE patients (mean 5.0, 0-18), (p=0.003). The average length of stay was similar. The commonest medications implicated were vasodilators, psychotropics and diuretics. The commonest adverse effects were postural hypotension and/or vasovagal syncope (29% of ADEs), intentional overdoses and recreational drug use (15%) and acute renal failure and/or clinical dehydration (10%). 76 patients had culprit medications stopped or reduced and this potentially contributed to six readmissions. Coding identified 61% of ADE associated admissions.
CONCLUSION: ADEs are a common cause of hospital admission. The most frequent problems are postural hypotension and vasovagal syncope, intentional drug misuse, and dehydration.
PMID: 24750276 [PubMed - as supplied by publisher]