Document Detail

Life-threatening adverse drug reactions at admission to medical intensive care: a prospective study in a teaching hospital.
MedLine Citation:
PMID:  17653528     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess the characteristics of life-threatening adverse drug reactions in patients admitted to medical intensive care unit and to define those that could facilitate early identification. DESIGN: A prospective 6-month observational study. PATIENTS: Of the 436 admissions to the teaching hospital medical intensive care unit, all patients aged over 15 years and who had received documented drug treatment were included (n = 405). MEASUREMENTS: Characteristics of patients [age, gender, underlying diseases, organ failure(s), drugs taken, Severity Acute Physiologic Score II, length of stay, outcome at discharge] were prospectively collected using a standardised questionnaire. A panel of experts assessed putative serious adverse drug reaction(s) for each drug taken and each organ failure at admission by using a standardised causality assessment method. Characteristics of patients with and without serious adverse drug reactions at admission were compared using univariate and then stepwise descending multivariate logistic regression. RESULTS: Of the 405 patients included, 111 (27.4%) presented an adverse drug reaction leading to organ failure. In 48% of cases adverse drug reactions were preventable, 23% were undiagnosed and 19% contributed to death. Age over 75 years [odds ratio (OR) 2.25; 95% confidence interval (CI) 1.15-4.38; p = 0.02], having more than three drugs (OR 6.90; 95% CI 1.44-33.00; p = 0.02) and a diagnosis of haematological malignancy (OR 6.19; 95% CI 2.07-18.53; p = 0.001) were independently associated with serious adverse drug reactions. CONCLUSIONS: Preventable life-threatening adverse drug reactions were frequently involved in organ failure at admission to medical intensive care; many of them had not been identified.
Marieke Grenouillet-Delacre; Hélène Verdoux; Nicholas Moore; Françoise Haramburu; Ghada Miremont-Salamé; Gabriel Etienne; Philip Robinson; Didier Gruson; Gilles Hilbert; Claude Gabinski; Bernard Bégaud; Mathieu Molimard
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Publication Detail:
Type:  Journal Article     Date:  2007-07-25
Journal Detail:
Title:  Intensive care medicine     Volume:  33     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-11-23     Completed Date:  2008-05-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2150-7     Citation Subset:  IM    
Université Victor Segalen Bordeaux 2, INSERM U657, 146 rue Léo Saignat, 33075 Bordeaux cedex, France.
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MeSH Terms
Drug Toxicity / complications,  epidemiology*
France / epidemiology
Hospitals, Teaching*
Intensive Care Units*
Middle Aged
Multiple Organ Failure
Patient Admission*
Prospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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