[Incidence of adverse drug reactions in a pediatric teaching hospital: a retrospective study from 1989 to 2010]

Abstract

Objective: The main objective is to describe the incidence of adverse drug reactions (ADR) coded by medical archivists from patient medical records. The secondary objective is to determine the drug classes causing ADRs according to age and to compare the incidence according to the revision of the International Classification of Diseases (ICD) used.

Methods: This is a non experimental and descriptive study of ADR in a teaching hospital. All ADR codes (i.e. codes E930 to E949 in ICD-9 version and codes Y40 to Y59 in ICD-10 version) in medical records of patients aged 18 and under have been included. The research protocol has been accepted by the institutional review board committee of CHU Sainte-Justine.

Results: We calculated on average 225.7±65.1 ADRs coded per year for an annual average incidence of pediatric ADRs of 1.64%±0.41% (n=4740 ADRs, average 1.3 ADR per patient) for a total of 294,480 admissions between April 1st, 1989 and March 31st, 2010. ADRs coded occurred amongst 0 to 2 years old and 12 to18 years old in a proportion of 30.5% and amongst 3 to 11 years old in a proportion of 39%. ADRs are caused by antibiotics (28%), anticancer drugs (18%), opiates (6%) and steroids (6%) which represent around 50% of all ADRs.

Conclusion: The incidence of pediatric ADRs is increasing throughout the studied period, mainly because a more complete codification of episodes of care by medical archivists has been prioritized by the hospital administration.