Adverse drug events in an intensive care unit of a university hospital

Reis, Adriano Max Moreira; Cassiani, Sílvia Helena De Bortoli

doi:10.1007/s00228-010-0987-y

Cited by 69 publications

(72 citation statements)

References 35 publications

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“…The incidence of adverse drug events in this study was similar to that found in other studies: Switzerland (15.4%), England (15.8%) and United States (16.4%) 4,40,44 . Brazilian studies conducted by Rozenfeld et al 45 , Roque & Melo 46 , Giordani et al 47 and Reis & Cassiani 23 identified the occurrence of adverse drug events, with frequencies between 7% and 15.6%, similar to that of this study. These studies 23,45,46,47 were based on the approach proposed by IHI 25 , using trigger tool, showing reproducibility in other contexts.…”

Section: (24 Days Of Icu Stay) the Relationship Betweensupporting

confidence: 88%

“…The proportion of deaths in intensive care in this study was similar to that of the Canadian study 13 (25%; 95%CI: [19][20][21][22][23][24][25][26][27][28][29][30][31] in that patients with adverse events had higher odds of dying in intensive care. A cohort study carried out in French ICUs identified a positive association between occurrence of two or more adverse events and death (OR = 3.09; 95%CI: 1.30-7.36) 14 .…”

Section: (24 Days Of Icu Stay) the Relationship Betweensupporting

confidence: 73%

“…However, just as in other studies 23,47 , in this study, we used the Naranjo et al 26 algorithm in order to evaluate the causality of adverse drug events. The use of this algorithm reduced judgment subjectivity in the consensus meetings.…”

Section: (24 Days Of Icu Stay) the Relationship Betweenmentioning

confidence: 99%

“…The high variability observed in estimates can be partly explained by notification and information obtainment mechanisms, and processes for classifying the event and possible damage (who determines the classification and how). The most frequently used methods in investigating adverse events are voluntary notification and retrospective review of medical records, which have limitations in identifying associated risk factors and determining the chain of causality 15,21,22,23 .…”

Section: Introductionmentioning

confidence: 99%

“…In these studies, the most frequent adverse events were infections associated with care, procedure complications and adverse drug events. In Brazil, the main studies that analyzed adverse events in intensive therapy used a sectional approach with medical record review or voluntary notification 21,22,23 . In a cohort study on 195 patients admitted for clinical reasons in São Paulo, 81.7% had an adverse events.…”

Section: Introductionmentioning

confidence: 99%

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Adverse events in the intensive care unit: impact on mortality and length of stay in a prospective study

2016

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This study sought to evaluate the occurrence of adverse events and their impacts on length of stay and mortality in an intensive care unit (ICU). This is a prospective study carried out in a teaching hospital in Rio de Janeiro, Brazil. The cohort included 355 patients over 18 years of age admitted to the ICU between August 1, 2011 and July 31, 2012. The process we used to identify adverse events was adapted from the method proposed by the Institute for Healthcare Improvement. We used a logistical regression to analyze the association between adverse event occurrence and death, adjusted by case severity. We confirmed 324 adverse events in 115 patients admitted over the year we followed. The incidence rate was 9.3 adverse events per 100 patients-day and adverse event occurrence impacted on an increase in length of stay (19 days) and in mortality (OR = 2.047; 95%CI: 1.172-3.570). This study highlights the serious problem of adverse events in intensive care and the risk factors associated with adverse event incidence.

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Section: (24 Days Of Icu Stay) the Relationship Betweensupporting

confidence: 88%

Section: (24 Days Of Icu Stay) the Relationship Betweensupporting

confidence: 73%

Section: (24 Days Of Icu Stay) the Relationship Betweenmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Adverse events in the intensive care unit: impact on mortality and length of stay in a prospective study

2016

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Potential drug-drug interactions in cardiothoracic intensive care unit of a pulmonary teaching hospital

Farzanegan

Alehashem

Bastani

et al. 2014

The Journal of Clinical Pharmacology

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Little is known about clinically significant drug-drug interactions (DDIs) in respiratory settings. DDIs are more likely to occur in critically ill patients due to complex pharmacotherapy regimens and organ dysfunctions. The aim of this study was to identify the pattern of potential DDIs (pDDIs) occurring in cardiothoracic intensive care unit (ICU) of a pulmonary hospital. A prospective observational study was conducted for 6 months. All pDDIs for admitted patients in cardiothoracic ICU were identified with Lexi-Interact program and assessed by a clinical pharmacologist. The interacting drugs, reliability, mechanisms, potential outcomes, and clinical management were evaluated for severe and contraindicated interactions. The study included 195 patients. Lung cancer (14.9%) was the most common diagnosis followed by tracheal stenosis (14.3%). The rate of pDDIs was 720.5/100 patients. Interactions were more commonly observed in transplant patients. 17.7% of pDDIs were considered as severe and contraindicated interactions. Metabolism (54.8%) and additive (24.2%) interactions were the most frequent mechanisms leading to pDDIs, and azole antifungals and fluoroquinolones were the main drug classes involved. The pattern of pDDIs in cardiothoracic ICU differs from other ICU settings. Specialized epidemiological knowledge of drug interactions may help clinical practitioners to reduce the risk of adverse drug events.

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Analysis of Potential Drug‐Drug Interactions in Medical Intensive Care Unit Patients

et al. 2014

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Potential drug-drug interactions occur in 54% of all ICU patients, which is two times more than the rate seen in patients on general wards. A limited set of 20 pDDI pairs is responsible for more than 90% of all pDDIs. Therefore, it is worthwhile to develop guidelines for the management of these specific pDDIs. As the vast majority of the interactions can be managed by monitoring, advanced clinical decision support systems linking laboratory data to prescription data may be an effective risk management strategy.

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Adverse drug events in an intensive care unit of a university hospital

Abstract: Adverse drug reactions of clinical significance were the most frequent ADEs in the ICU studied, which reduces patient safety. The number of ADEs related to drug interactions was small, suggesting that clinical manifestations of drug interactions that harm patients are not frequent in ICUs.

Cited by 69 publications

References 35 publications

Adverse events in the intensive care unit: impact on mortality and length of stay in a prospective study

Adverse events in the intensive care unit: impact on mortality and length of stay in a prospective study

Potential drug-drug interactions in cardiothoracic intensive care unit of a pulmonary teaching hospital

Analysis of Potential Drug‐Drug Interactions in Medical Intensive Care Unit Patients

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