Effect of adverse drug reactions on length of stay in surgical intensive care units

Vargas, Emilio; Terleira, Ana; Trancho, Florentino Hernando; Pérez, E. Rodríguez-Salinas; Cordón, Carmen; Moreno, A.; Portolés, Antonio

doi:10.1097/01.ccm.0000049947.80131.ed

Cited by 68 publications

(39 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There are several stages in the medication process, from the supply of drugs and their storage in the clinical area to drug prescription, preparation, administration and monitoring the response to treatment. The multiple risks in each of these stages have resulted in many reports of medicationrelated harm or potential harm to critically ill patients [1][2][3][4][5][6][7]. In one of these studies [5], medication errors accounted for over 60% of all reported adverse incidents in critical care, while in another study almost 10% of patients in intensive care suffered an adverse drug event [7].…”

Section: Discussionmentioning

confidence: 99%

Medication‐related patient safety incidents in critical care: a review of reports to the UK National Patient Safety Agency*

Thomas¹,

Panchagnula

2008

Anaesthesia

View full text Add to dashboard Cite

SummaryWe reviewed all patient safety incidents reported to the UK National Patient Safety Agency between 1st August 2006 and 28th February 2007 from intensive care or high dependency units. Incidents involving medications were then categorised. 12 084 incidents were submitted from 151 organisations (median 40, range 1-634 ⁄ organisation). 2428 incidents were associated with medication use involving 355 different drugs, most commonly morphine (207 incidents), gentamicin (190 incidents) and noradrenaline (133 incidents). Noradrenaline (55 incidents of harm) and insulin (48 incidents of harm) were most commonly associated with patient harm. Sixty-one percent of medication incidents were associated with drug administration and 26% with prescription. Two hundred and eighty-seven medication incidents caused temporary harm and 43 more than temporary harm. Five per cent of medication incidents were associated with staff communication during transfer from theatre or recovery. Categorisation of medication-associated incidents has allowed us to suggest changes to improve the reporting of incidents and to improve medication safety.

show abstract

Section: Discussionmentioning

confidence: 99%

Medication‐related patient safety incidents in critical care: a review of reports to the UK National Patient Safety Agency*

Thomas¹,

Panchagnula

2008

Anaesthesia

View full text Add to dashboard Cite

show abstract

“…The cost-generating components were decided based on published literature [8,[18][19][20][21], and the researchers' conservative estimates. Monetary values for the components were determined from national statistics [22][23][24] and personal communications with register holders [Gyllensten H. Personal communication] on costs of healthcare and drug utilisation.…”

Section: Cost-of-illness Analysesmentioning

confidence: 99%

Modelling drug-related morbidity in Sweden using an expert panel of physicians

Hakkarainen

Alström

Hägg

et al. 2012

Eur J Clin Pharmacol

View full text Add to dashboard Cite

Results: Physicians estimated that 51±22% (mean±SD) of outpatients experience DRM and 12±8% preventable DRM. Of inpatients, 54±17% was estimated to experience DRM and 16±7% preventable DRM. Of outpatients with DRM, 23±11% was estimated to experience preventable DRM, while this proportion for inpatients was 30±15%. The estimated COI was EUR 376 per outpatient and EUR 838 per inpatient. Conclusions:Swedish physicians estimated that every other outpatient and inpatient experiences DRM, which is often preventable and costly. As physicians' estimates on the proportion of patients with DRM were higher than in observational studies in restricted sub-populations, DRM may be more common in the general population than observational studies suggest.

show abstract

“…Although no adverse drug reactions with the antifungal agents were documented in this study, underrecognition and underreporting of adverse drug reactions common (1,(5)(6)(7)12). In fact, adverse drug reactions are recognized as being present in at least 6% of hospitalized patients and have been documented as causing increased lengths of stay (12,13,19). Fluconazole and ketoconazole have similar mechanisms of action, and so they share similar drug-drug interactions (R. Polk, Program Abstr.…”

Section: Vol 41 2003 Benefits Of Limited Yeast Id In Respiratory Sementioning

confidence: 99%

Improved Outcomes Associated with Limiting Identification of Candida spp. in Respiratory Secretions

et al. 2003

View full text Add to dashboard Cite

Pneumonia due to infection with Candida spp. is extremely rare even though these yeasts are commonly cultured from respiratory secretions. The diagnosis of pneumonia due to Candida spp. should be made only by demonstrating tissue invasion of a biopsy specimen. Physicians might misinterpret the presence of Candida spp. in respiratory secretions as being the etiological agent of pneumonia. This study describes the practice of limiting identification (ID) of rapidly growing yeasts (i.e., Candida spp.) in respiratory secretions and its impact on patients. Before November 2001, rapidly growing yeasts found in respiratory secretions were identified to the species level. After November, rapidly growing yeasts were reported as "yeasts, not Cryptococcus." The group of patients with respiratory secretions processed before November 2001 is called the full ID group (n ‫؍‬ 267); the group with samples processed after that date is called the limited ID group (n ‫؍‬ 77). Full ID patients had an average length of hospital stay of 12.1 days/patient; that of limited ID patients was 10.1 days/patient, a decrease of 2 days/patient (P ‫؍‬ 0.02). The full ID patients had an average cost of $9,407/patient; that of limited ID patients was $6,973/patient, a decrease of $2,434/patient (P ‫؍‬ 0.03). Antifungal medications were used in 103 of 267 (39%) full ID patients and in 16 of 77 (21%) limited ID patients, a decrease of 18% (P ‫؍‬ 0.004). Limited ID patients had a mortality rate of 14.3%; that of full ID patients was 18.7%, a decrease of 4.4% (P ‫؍‬ 0.37). This policy of limiting yeast ID did not impair the diagnosis of pneumonia. Rather, decreases in lengths of stay, costs, and administration of unnecessary antifungal therapy were observed after instituting this policy.

show abstract

Effect of adverse drug reactions on length of stay in surgical intensive care units

Abstract: Adverse drug reactions are a significant clinical and economic problem in surgical intensive care units.

Cited by 68 publications

References 37 publications

Medication‐related patient safety incidents in critical care: a review of reports to the UK National Patient Safety Agency*

Medication‐related patient safety incidents in critical care: a review of reports to the UK National Patient Safety Agency*

Modelling drug-related morbidity in Sweden using an expert panel of physicians

Improved Outcomes Associated with Limiting Identification of Candida spp. in Respiratory Secretions

Contact Info

Product

Resources

About