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. 2018 Apr 13;115(15):251-258.
doi: 10.3238/arztebl.2018.0251.

Adverse Drug Reactions (ADR) and Emergencies

A Marlen Schurig  1 , Miriam Böhme, Katja S Just, Catharina Scholl, Harald Dormann, Bettina Plank-Kiegele, Thomas Seufferlein, Ingo Gräff, Matthias Schwab, Julia C Stingl
Affiliations

Adverse Drug Reactions (ADR) and Emergencies

A Marlen Schurig et al. Dtsch Arztebl Int. .

Abstract

Background: Adverse drug reactions (ADR) are a common reason for emergency room visits and for hospitalization. An ADR is said to have occurred when the patient's symptoms and signs are considered to be possibly, probably, or definitely related to the intake of a drug.

Methods: In four large hospital emergency departments, one in each of four German cities ( Ulm, Fürth, Bonn, and Stuttgart), the percentage of suspected ADR cases among all patients presenting to the emergency room was determined during a 30-day period of observation. ADRs were ascertained by screening the digital records of all patients seen in the emergency room; causality was assessed as specified by the WHO-UMC (Uppsala Monitoring Center).

Results: ADR were sought in a total of 10 174 emergency department visits. 665 cases of suspected ADR were found, yielding a prevalence of 6.5%. The prevalence of ADR among patients with documented drug intake was 11.6%. Among the patients with documented suspected ADRs, 89% were hospitalized (in contrast to the 43.7% hospitalization rate in the entire group of 10 174 emergency department visits). A possible causal relationship between the patient's symptoms and signs and the intake of a drug was found in 74-84% of cases. Patients with ADR were found to be taking a median of 7 different drugs simultaneously.

Conclusion: Adverse drug reactions are a relevant cause of emergency department visits, accounting for 6.5% of the total visits in this study, and often lead to hospital admission. The ADRED (Adverse Drug Reactions in Emergency Departments) study, which is now being conducted, is intended to shed further light on their causes, patient risk factors, and potential avoidability.

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Figures

Figure 1
Figure 1
Flowchart for the inclusion of adverse drug reactions (ADRs)
Figure 2
Figure 2
Age and sex of the 350 patients who were included in the study
Figure 3
Figure 3
Box plot depiction of the drugs taken by the 350 patients with adverse drug reactions (ADRs) by age group. The number of active ingredients that were taken at the same time is shown on the y-axis. Outlier values are marked with *, and extreme values, with °.
Figure 4
Figure 4
Distribution of the causality assessment of the 352 cases with suspected adverse drug reaction (ADR)
Figure 5
Figure 5
Condition of patients with adverse drug reactions (ADRs) at discharge from hospital (352 suspected ADR cases)
Figure 6
Figure 6
Characteristics of suspected ADR cases: relative frequency of cases with at least one symptom of the corresponding system organ class
Figure 7
Figure 7
Characteristics of suspected ADR cases: relative frequency of cases with at least one ADR-associated drug of the corresponding drug group
Figure 8
Figure 8
Comparison of adults (18–64 years old, N= 86) and elderly adults (= 65 years old, N= 266) with a possible, probable, or certain adverse drug reaction (ADR) in terms of: a) Treatment status b) Causality assessment
See this image and copyright information in PMC

Comment in

References

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