Format

Send to

Choose Destination
Eur J Clin Pharmacol. 2016 Feb;72(2):219-26. doi: 10.1007/s00228-015-1974-0. Epub 2015 Nov 7.

Adverse drug reactions leading to urgent hospital admission in an elderly population: prevalence and main features.

Author information

1
Clinical Pharmacology Department, Bellvitge University Hospital, c/ Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain. cpedros@bellvitgehospital.cat.
2
Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain. cpedros@bellvitgehospital.cat.
3
Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.
4
Internal Medicine Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.
5
Albert J. Jovell Institute of Public Health and Patients, Faculty of Medicine and Health Sciences, International University of Catalonia, Barcelona, Spain.
6
Clinical Pharmacology Department, Bellvitge University Hospital, c/ Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain.
7
Department of Pathology and Experimental Therapeutics, University of Barcelona, Barcelona, Spain.

Abstract

PURPOSE:

To assess the prevalence of urgent hospitalization due to adverse drug reactions (ADRs) in patients aged ≥ 65 years, to compare the in-hospital mortality rates between patients admitted for ADRs and those admitted for other causes, and to describe the ADRs, the used and suspected drugs, and the drug-reaction associations.

METHODS:

A cross-sectional study was conducted by using the institutional database of the Pharmacovigilance Programme of Bellvitge University Hospital, a 750-bed tertiary care hospital, with information corresponding to a 7-year period. ADR-related admissions of patients aged ≥ 65 years prospectively identified through a systematic daily review of all admission diagnosis were reviewed.

RESULTS:

ADRs were suspected to be the main reason for urgent admission in 1976 out of 60,263 patients aged ≥ 65 years (prevalence of ADR-related hospitalization 3.3 % [95 % CI 3.1-3.4 %]). The crude in-hospital mortality rate was 10.2 % in patients with ADR-related admission and 9 % in patients admitted for other causes (p = 0.077). Most patients (86 %) were exposed to polypharmacy, and a drug-drug interaction was suspected in 49 % of cases. The most frequent drug-reaction associations were acute renal failure related to renin-angiotensin system inhibitors, gastrointestinal bleeding caused by antithrombotics and/or non-steroidal anti-inflammatories, and intracranial bleeding induced by vitamin K antagonists.

CONCLUSIONS:

One out of every 30 urgent admissions of patients aged ≥ 65 years is ADR-related. These ADRs can be as serious and life-threatening as any other acute pathology that merits urgent hospital admission. Most cases involve patients exposed to polypharmacy and result from well-known reactions of a few commonly used drugs.

KEYWORDS:

Adverse drug reactions; Elderly; Hospitalization; Pharmacovigilance

PMID:
26546335
DOI:
10.1007/s00228-015-1974-0
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center