Drug‐related deaths in hospital inpatients: A retrospective cohort study

• Published in: British journal of clinical pharmacology 2018-03, Vol.84 (3), p.542-552
• Main Authors: Montané, Eva, Arellano, Ana Lucía, Sanz, Yolanda, Roca, Josep, Farré, Magí
• Format: Article
• Language: English
• Subjects: Adult; adverse drug reaction; Adverse Drug Reaction Reporting Systems - statistics & numerical data; Aged; Aged, 80 and over; Cause of Death; Cohort Studies; Drug Interactions; Drug Safety; Drug-Related Side Effects and Adverse Reactions - epidemiology; Drug-Related Side Effects and Adverse Reactions - mortality; epidemiology; Female; Hospital Mortality; Hospitalization; Hospitals, University; Humans; Incidence; Inpatients - statistics & numerical data; Length of Stay; Male; Middle Aged; Retrospective Studies; Risk Factors; Young Adult
• ISSN: 0306-5251; 1365-2125
• DOI: 10.1111/bcp.13471

Aims To determine the incidence of drug‐related deaths (DRD) in a university hospital in 2015, to describe their characteristics, and to discover risk factors of DRD. Methods An analytic and retrospective cohort study. Patients with a death diagnosed predefined from a list of medical conditions potentially caused by drugs were the selected cases for further review. Causality assessment was evaluated by a local drug safety committee. Results Out of 1135 inpatient deaths, 73 DRD were included (six were hospital‐acquired). The incidence of DRD of all hospital admissions was 0.34%, and the incidence of all deaths cases was 7%. Drugs were the cause of death in 38 patients (52%) and a contributive role in 35 (48%). The median age of DRD patients was 72 years (range 19–94) and 72.6% were men. The median hospital stay, Charlson score and number of drugs were 5 days, 2 points and seven drugs respectively. The most frequent DRD were cerebral haemorrhages and infections in drug‐immunosuppressed patients (32, 43.8%, each group). The most frequently involved drugs were antineoplastics and glucocorticosteroids (40% and 18%), and antithrombotics (33%); drug–drug interactions were present in 44% DRD. Sex, age and number of drugs were risk factors of DRD. Conclusions Adverse drug reactions were a significant cause of death in hospitalized patients, mainly haemorrhages and infections precipitated by drug–drug interactions. Risk factors for DRD were sex, age and number of drugs. Preventable DRD and measures to avoid them should be accurately assessed in further studies.