Readmissions and adverse drug reactions in internal medicine: the economic impact

Dormann, Harald; Neubert, Antje; Criegee-Rieck, Manfred; Egger, Tobias; Radespiel‐Tröger, Martin; Azaz-Livshits, Tanya; Levy, Micha; Brune, Kay; Hahn, Eckhart G.

doi:10.1111/j.1365-2796.2004.01326.x

Cited by 113 publications

(93 citation statements)

References 44 publications

(51 reference statements)

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“…Interestingly, 62.1% of the studies (18/29) 6,7,8,9,12,13,15,16,19,20,21,22,25,26,27,31,33,34 involved university, academic, or teaching hospitals, i.e., presumably large-scale, high-complexity hospital units.…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-eight articles remained 6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33 for evaluation, plus one more article retrieved by manual search 34 . Table 1 describes the studies, conducted in 13 countries from North America, Europe, South America, and Asia.…”

Section: Resultsmentioning

confidence: 99%

“…Most of the studies were performed in one hospital (19/29) 7,8,12,13,15,16,17,18,19,20,21,25,26,27,28,31,32,33,34 . Six were multi-center 6,9,22,23,24,29 and Figure 1 Flowchart of systematic article search and selection on in-hospital adverse drug events.…”

Section: Resultsmentioning

confidence: 99%

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Adverse drug events in hospitals: a systematic review

Cano

Rozenfeld

2009

Cad. Saúde Pública

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Adverse drug events in hospitals: a systematic review

Cano

Rozenfeld

2009

Cad. Saúde Pública

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“…Almost onethird of the patients have iatrogenic disease before hospital admission [20] and 3-7% of all admissions have iatrogenic causes [10,15,16,21,22], increasing to almost 8% in patients over 65 years of age [11]. Iatrogenic events are also an important cause of admission to intensive care units (ICUs) [23][24][25][26][27] and of hospital readmission [28,29]. Little epidemiological data is available [6,10].…”

Section: Introductionmentioning

confidence: 99%

The diseases we cause: Iatrogenic illness in a department of internal medicine

Madeira

Melo

Porto³

et al. 2007

European Journal of Internal Medicine

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Background: The aim of this study was to estimate the incidence, main causes, and risk factors of iatrogenic disease occurring in a department of internal medicine. Methods: Over a 1-year period, physicians systematically filled out a 2-page questionnaire for all patients admitted to the ward. A database was created and the data were statistically analyzed. Patients undergoing immunosuppressive, chemo-, or radiation therapy were excluded. Missing data were completed by reviewing the patients' charts. The patients were then divided into two groups: those with and those without iatrogenic disease. The groups were compared using several parameters including gender, age, social features, days of hospitalization, associated illness, functional status, medical impression, prognosis, associated renal or liver function impairment, drugs taken daily, and outcome. In the group with iatrogenic disease, the type, severity, and predictability were also analyzed. Results: Of the 879 patients admitted to the ward, 445 completed questionnaires and were included in the study. A total of 102 patients (22.9%) developed 121 iatrogenic events. Forty-four patients (43.1%) were admitted for iatrogenic illness, 10 (9.8%) developed lifethreatening events, and in 3 (6.8%) it was the cause of death. Fifty-eight patients (56.8%) registered 77 episodes of iatrogenic disease during their hospital stay, 20 (19.6%) developed life-threatening events, and 9 (11.7%) died, 4 (5.2%) of an iatrogenic cause (nosocomial infections). Significant differences were found in 20 out of 26 parameters studied ( p b 0.005 for all cases; 95% confidence interval). Eighteen percent of all iatrogenic disease was severe, 61.9% predictable, 54.5% avoidable, and 59% drug-related, 80% of which was due to side effects or adverse reactions. Infection and metabolic and electrolyte disorders were the most frequent effects. Conclusions: It is possible to identify risk factors for iatrogenic events. Chronically ill elderly inpatients are the main target of iatrogenic events.

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“…1 Similarly, according to a German study, about 6% of adverse drug reactions are attributed to new hospital admissions. 2 This inter-individual variability in drug response could be due to multiple factors such as disease determinants, genetic and environmental factors and variability in drug target response (pharmacodynamic response) or idiosyncratic response. These factors affect drug absorption, distribution, metabolism and excretion.…”

Section: Introductionmentioning

confidence: 99%