Mortality among patients due to adverse drug reactions that lead to hospitalization: a meta-analysis
Purpose The aim of this study was to estimate the prevalence of mortality among patients due to adverse drug reactions that lead to hospitalisation (fatal $ ADR_{Ad} $), to explore the heterogeneity in its estimation through subgroup analysis of study characteristics, and to identify system-organ classes involved and causative drugs for fatal $ ADR_{Ad} $. Methods We identified prospective $ ADR_{Ad} $-related studies via screening of the PubMed and Google Scholar databases with appropriate key terms. We estimated the prevalence of fatal $ ADR_{Ad} $ using a double arcsine method and explored heterogeneity using the following study characteristics: age groups, wards, study region, ADR definitions, ADR identification methods, study duration and sample size. We examined patterns of fatal $ ADR_{Ad} $ and causative drugs. Results Among 312 full-text articles assessed, 49 studies satisfied the selection criteria and were included in the analysis. The mean prevalence of fatal $ ADR_{Ad} $ was 0.20% (95% CI: 0.13–0.27%; I2 = 93%). The age groups and study wards were the important heterogeneity modifiers. The mean fatal $ ADR_{Ad} $ prevalence varied from 0.01% in paediatric patients to 0.44% in the elderly. Subgroup analysis showed a higher prevalence of fatal $ ADR_{Ad} $ in intensive care units, emergency departments, multispecialty wards and whole hospitals. Computer-based monitoring systems in combination with other methods detected higher mortality. Intracranial haemorrhage, renal failure and gastrointestinal bleeding accounted for more than 50% of fatal $ ADR_{Ad} $cases. Warfarin, aspirin, renin–angiotensin system (RAS) inhibitors and digoxin accounted for 60% of fatal $ ADR_{Ad} $. Conclusions $ ADR_{Ad} $ is an important cause of mortality. Strategies targeting the safer use of warfarin, aspirin, RAS inhibitors and digoxin could reduce the large number of fatal $ ADR_{Ad} $cases..
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2018 |
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| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:74 |
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| Enthalten in: |
European journal of clinical pharmacology - 74(2018), 6 vom: 19. März, Seite 819-832 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Patel, Tejas K. [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Themen: |
Adverse drug reaction |
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| Anmerkungen: |
© Springer-Verlag GmbH Germany, part of Springer Nature 2018 |
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| doi: |
10.1007/s00228-018-2441-5 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
SPR002593238 |
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| 520 | |a Purpose The aim of this study was to estimate the prevalence of mortality among patients due to adverse drug reactions that lead to hospitalisation (fatal $ ADR_{Ad} $), to explore the heterogeneity in its estimation through subgroup analysis of study characteristics, and to identify system-organ classes involved and causative drugs for fatal $ ADR_{Ad} $. Methods We identified prospective $ ADR_{Ad} $-related studies via screening of the PubMed and Google Scholar databases with appropriate key terms. We estimated the prevalence of fatal $ ADR_{Ad} $ using a double arcsine method and explored heterogeneity using the following study characteristics: age groups, wards, study region, ADR definitions, ADR identification methods, study duration and sample size. We examined patterns of fatal $ ADR_{Ad} $ and causative drugs. Results Among 312 full-text articles assessed, 49 studies satisfied the selection criteria and were included in the analysis. The mean prevalence of fatal $ ADR_{Ad} $ was 0.20% (95% CI: 0.13–0.27%; I2 = 93%). The age groups and study wards were the important heterogeneity modifiers. The mean fatal $ ADR_{Ad} $ prevalence varied from 0.01% in paediatric patients to 0.44% in the elderly. Subgroup analysis showed a higher prevalence of fatal $ ADR_{Ad} $ in intensive care units, emergency departments, multispecialty wards and whole hospitals. Computer-based monitoring systems in combination with other methods detected higher mortality. Intracranial haemorrhage, renal failure and gastrointestinal bleeding accounted for more than 50% of fatal $ ADR_{Ad} $cases. Warfarin, aspirin, renin–angiotensin system (RAS) inhibitors and digoxin accounted for 60% of fatal $ ADR_{Ad} $. Conclusions $ ADR_{Ad} $ is an important cause of mortality. Strategies targeting the safer use of warfarin, aspirin, RAS inhibitors and digoxin could reduce the large number of fatal $ ADR_{Ad} $cases. | ||
| 650 | 4 | |a Adverse drug reaction |7 (dpeaa)DE-He213 | |
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| 700 | 1 | |a Patel, Parvati B. |4 aut | |
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