Mortalidad hospitalaria asociada a medicamentos en un Servicio de Medicina Interna

  1. Pardo-Cabello, A.J. 1
  2. Manzano-Gamero, V. 2
  3. Del-Pozo, E. 3
  4. Gómez-Jiménez, F.J. 4
  5. Luna-del Castillo, J.D. 5
  6. Puche-Cañas, E. 6
  1. 1 Servicio de Medicina Interna. Hospital Clínico San Cecilio. Granada, España.
  2. 2 Servicio de Medicina Interna. Hospital Universitario Virgen de las Nieves. Granada, España.
  3. 3 Departamento de Farmacología. Facultad de Medicina. Instituto de Investigación Biomédica ibs. Universidad de Granada. Granada, España.
  4. 4 Departamento de Medicina. Facultad de Medicina. Universidad de Granada. Granada, España.
  5. 5 Departamento de Bioestadística. Facultad de Medicina. Universidad de Granada. Granada, España.
  6. 6 Departamento de Farmacología. Facultad de Medicina. Universidad de Granada. Granada, España.
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Zeitschrift:
Anales del sistema sanitario de Navarra

ISSN: 1137-6627

Datum der Publikation: 2018

Ausgabe: 41

Nummer: 3

Seiten: 339-346

Art: Artikel

DOI: 10.23938/ASSN.0381 DIALNET GOOGLE SCHOLAR lock_openOpen Access editor

Andere Publikationen in: Anales del sistema sanitario de Navarra

Zusammenfassung

Background. To analyze the mortality associated with prescriptions, the drugs most frequently involved and the associated risk factors in patients admitted to Internal Medicine.Methods. A retrospective, observational study. The clinical records of adult patients who died consecutively in the department of Internal Medicine in a Spanish tertiary hospital over twenty-two months were reviewed. The main variable was the prevalence of hospital death suspected of being related to the medications administered during admission.Results. Out of the 455 deaths analyzed, 22.2% were related to the medications received; in 55 cases (12.1%) the drugs were suspected of being the cause of death and in 46 cases (10.1%) of contributing to it. The most frequent diagnoses in cases of death associated with drugs were cardiac arrhythmia (23.7%), severe hemorrhage (19.8%) and aspiration pneumonia (12.8%). The drugs with the highest prevalence in deaths related to pharmacological treatment were antithrombotic drugs (23.7%), digoxin (21.7%), antipsychotics (17.8%) and benzodiazepines (14.8%). The only independent risk factor for mortality associated with treatment was the number of medications administered (OR=1.25, 95%CI: 1.14-1.37). No significant association was found with age, sex, number of pathologies or duration of hospital stay.Conclusion. A high percentage of deaths of patients admitted to Internal Medicine were considered related to the medications received. Antithrombotic drugs, digoxin and psychotropic drugs were the agents most frequently implicated. This mortality is independently and significantly associated with the number of medications administered.

Bibliographische Referenzen

  • BOEKER EB, DE BOER M, KIEWIET JJ, LIE-A-HUEN L, DIJKGRAAF MG, BOERMEESTER MA. Occurrence and preventability of adverse drug events in surgical patients: a systematic review of literature. BMC Health Serv Res 2013; 13: 364. doi: 10.1186/1472-6963-13-364.
  • HUG BL, KEOHANE C, SEGER DL, YOON C, BATES DW. The costs of adverse drug events in community hospitals. Jt Comm J Qual Patient Saf 2012; 38: 120-126.
  • KALISCH ELLETT LM, PRATT NL, RAMSAY EN, BARRATT JD, ROUGHEAD EE. Multiple anticholinergic medication use and risk of hospital admission for confusion or dementia. J Am Geriatr Soc 2014; 62: 1916-1922.
  • KHAN LM. Comparative epidemiology of hospital-acquired adverse drug reactions in adults and children and their impact on cost and hospital stay a systematic review. Eur J Clin Pharmacol 2013; 69: 1985-1996.
  • LEPORINI C, DE SARRO G, RUSSO E. Adherence to therapy and adverse drug reactions: is there a link? Expert Opin Drug Saf 2014; 13 (Suppl 1): 41-55.
  • BLIX HS, VIKTIL KK, REIKVAM A, MOGER TA, HJEMAAS BJ, PRETSCH P et al. The majority of hospitalised patients have drug-related problems: results from a prospective study in general hospitals. Eur J Clin Pharmacol 2004; 60: 651-658.
  • DAVIES EC, GREEN CF, MOTTRAM DR, PIRMOHAMED M. Adverse drug reactions in hospital in-patients: a pilot study. J Clin Pharm Ther 2006; 31: 335-341.
  • DAVIES EC, GREEN CF, TAYLOR S, WILLIAMSON PR, MOTTRAM DR, PIRMOHAMED M. Adverse drug reactions in hospital in-patients: a prospective analysis of 3695 patient-episodes. PLoS one 2009; 4: e4439. doi: 10.1371/journal.pone.0004439.
  • EBBESEN J, BUAJORDET I, ERIKSSEN J, BRØRS O, HILBERG T, SVAAR H et al. Drug-related deaths in a department of internal medicine. Arch Intern Med 2001; 161: 2317-2323.
  • JUNTTI-PATINEN L, NEUVONEN PJ. Drug-related deaths in a university central hospital. Eur J Clin Pharmacol 2002; 58: 479-482.
  • KELLY WN. Potential risks and prevention, part 1: fatal adverse drug events. Am J Health Syst Pharm 2001; 58: 1317-1324.
  • LAZAROU J, POMERANZ BH, COREY PN. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA 1998; 279: 12001205.
  • MOORE TJ, COHEN MR, FURBERG CD. Serious adverse drug events reported to the Food and Drug Administration 1998-2005. Arch Intern Med 2007; 167: 1752-1759.
  • MOUTON JP, MEHTA U, PARRISH AG. Mortality from adverse drug reactions in adult medical inpatients at four hospitals in South Africa: a cross-sectional survey. Br J Clin Pharmacol 2015; 80: 818-826.
  • RIVKIN A. Admissions to amedical intensive care unit related to adverse drug reactions. Am J Health Syst Pharm 2007; 64: 1840-1843.
  • WESTER K, JÖNSSON AK, SPIGSET O, DRUID H, HÄGG S. Incidence of fatal adverse drug reactions: a population based study. Br J Clin Pharmacol 2008; 65: 573-579.
  • ZOPPI M, BRAUNSCHWEIG S, KUENZI UP, MAIBACH R, HOIGNÉ R. Incidence of lethal adverse drug reactions in the comprehensive hospital drug monitoring, a 20-year survey, 1974-1993, based on the data of Berne/St. Gallen. Eur J Clin Pharmacol 2000; 56: 427-430.
  • PUCHE CAÑAS E, LUNA DEL CASTILLO JD. Adverse drug reactions in patients visiting a general hospital: a meta-analysis of results. An Med Interna 2007; 24: 574-578.
  • PARDO CABELLO AJ, GONZÁLEZ CONTRERAS LG, MANZANO GAMERO MV, GÓMEZ JIMÉNEZ FJ, PUCHE E. Prevalence of fatal adverse drug reactions in hospitalized patients. Int J Clin Pharmacol Ther 2009; 47: 596-602.
  • American Society of Health-System Pharmacists. Best practices for health-system pharmacy: positions and practice standards of ASHP 1999-2000. Bethesda, EE. UU. 1999. ISBN: 1-979907-99-2.
  • NARANJO CA, BUSTO U, SELLERS EM. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 1981; 30: 239-245.
  • ZAPATERO-GAVIRIA A, BARBA-MARTÍN R, CANORA-LEBRATO J, FERNÁNDEZ-PÉREZ C, GOMEZ-HUELGAS R, BERNAL-SOBRINO JL et al. RECALMIN II. Eight years of hospitalisation in Internal Medicine Units (2007-2014). What has changed? Rev Clin Esp 2017; 217: 446-453.
  • RATHORE SS, WANG Y, KRUMHOLZ HM. Sex-based differences in the effect of digoxin for the treatment of heart failure. N Engl J Med 2002; 347: 1403-1411.
  • VAN DER MAAREL-WIERINK CD, VANOBBERGEN JN, BRONKHORST EM, SCHOLS JM, DE BAAT C. Risk factors for aspiration pneumonia in frail older people: a systematic literature review. J Am Med Dir Assoc 2011; 12: 344-354.
  • ZETIN M. Psychopharmacohazardology: major hazards of the new generation of psychotherapeutic drugs. Int J Clin Pract 2004; 58: 58-68.
  • BUAJORDET I, EBBESEN J, ERIKSSEN J, BRØRS O, HILBERG T. Fatal adverse drug events: the paradox of drug treatment. J Intern Med 2001; 250: 327-341.
  • LESSING C, SCHMITZ A, ALBERS B, SCHRAPPE M. Impact of sample size on variation of adverse events and preventable adverse events: systematic review on epidemiology and contributing factors. Qual Saf Health Care 2010; 19: e24. doi: 10.1136/qshc.2008.031435.
  • MORIMOTO T, GANDHI TK, SEGER AC, HSIEH TC, BATES DW. Adverse drug events and medication errors: detection and classification methods. Qual Saf Health Care 2004; 13: 306-314.
  • LAU HS, FLORAX C, PORSIUS AJ, DE BOER A. The completeness of medication histories in hospital medical records of patients admitted to general internal medicine wards. Br J Clin Pharmacol 2000; 49: 597-603.
Fuente de los datos: Dialnet