Influence of adverse drug events on morbidity and mortality in intensive care units: the JADE study

Abstract

Objective: To identify the influence of adverse drug events (ADEs) on morbidity and mortality in intensive care units (ICUs).

Design: A prospective cohort study.

Setting: ICU setting at three acute care hospitals in Japan.

Participants: All patients aged ≥15 years were admitted to all ICUs during a 6-month study period.

Intervention: No intervention.

Main outcome measures: Mortality in the ICUs and the length of the ICU stay. .

Results: We included 459 patients with a total of 3231 patient-days. Ninety-nine ADEs occurred in 70 patients (15%), so that the incidence of ADEs was 30.6 per 1000 patient-days and 21.6 ADEs per 100 admissions. Seventy-three patients (16%) died during their ICU stay. Excluding 38 deaths within 3 days after admission, 12 patients (17%) died among the 70 patients who had at least one ADE during their ICU stay and 23 (7%) died among 351 without an ADE (P = 0.003). The median ICU length of stay was 3 days. Excluding 73 patients who died during their ICU stay, the median ICU stay of patients with at least one ADE was 13 days, while it was only 2 days in the remainder (P < 0.0001). ADEs were associated with longer length of ICU stay but not with mortality even after adjusting for patients' severity of illness.

Conclusions: ADEs were common in ICUs and significantly associated with longer length of ICU stay but did not influence on mortality.

Keywords: adverse drug events; and patient safety; epidemiology; intensive care unit; length of ICU stay; mortality.