Mortality among patients due to adverse drug reactions that lead to hospitalization: a meta-analysis
Purpose The aim of this study was to estimate the prevalence of mortality among patients due to adverse drug reactions that lead to hospitalisation (fatal ADR Ad ), to explore the heterogeneity in its estimation through subgroup analysis of study characteristics, and to identify system-organ classes...
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| Veröffentlicht in: | European journal of clinical pharmacology 2018-06, Vol.74 (6), p.819-832 |
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| container_title | European journal of clinical pharmacology |
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| creator | Patel, Tejas K. Patel, Parvati B. |
| description | Purpose
The aim of this study was to estimate the prevalence of mortality among patients due to adverse drug reactions that lead to hospitalisation (fatal ADR
Ad
), to explore the heterogeneity in its estimation through subgroup analysis of study characteristics, and to identify system-organ classes involved and causative drugs for fatal ADR
Ad
.
Methods
We identified prospective ADR
Ad
-related studies via screening of the PubMed and Google Scholar databases with appropriate key terms. We estimated the prevalence of fatal ADR
Ad
using a double arcsine method and explored heterogeneity using the following study characteristics: age groups, wards, study region, ADR definitions, ADR identification methods, study duration and sample size. We examined patterns of fatal ADR
Ad
and causative drugs.
Results
Among 312 full-text articles assessed, 49 studies satisfied the selection criteria and were included in the analysis. The mean prevalence of fatal ADR
Ad
was 0.20% (95% CI: 0.13–0.27%;
I
2
= 93%). The age groups and study wards were the important heterogeneity modifiers. The mean fatal ADR
Ad
prevalence varied from 0.01% in paediatric patients to 0.44% in the elderly. Subgroup analysis showed a higher prevalence of fatal ADR
Ad
in intensive care units, emergency departments, multispecialty wards and whole hospitals. Computer-based monitoring systems in combination with other methods detected higher mortality. Intracranial haemorrhage, renal failure and gastrointestinal bleeding accounted for more than 50% of fatal ADR
Ad
cases. Warfarin, aspirin, renin–angiotensin system (RAS) inhibitors and digoxin accounted for 60% of fatal ADR
Ad
.
Conclusions
ADR
Ad
is an important cause of mortality. Strategies targeting the safer use of warfarin, aspirin, RAS inhibitors and digoxin could reduce the large number of fatal ADR
Ad
cases. |
| doi_str_mv | 10.1007/s00228-018-2441-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2015839913</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2015451554</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-f0868cab07050e52fc10a3dcbf9a728317ec4441fb9579b4155ff1837acd57443</originalsourceid><addsrcrecordid>eNp1kU1r3DAQhkVpaLZJf0AvRdBLLkpGXys7txLSNpDSS3MWY1neONjWVpIDm18fGacNFHrSYZ55RjMvIR85nHMAc5EAhKgY8IoJpTjTb8iGKykYB8Xfkg2A5GxbGzgm71N6AOC6BvmOHIta6-220hvS_ggx49DnA8UxTDu6x9z7KSfazp7mQLF99DF52sZ5R6NHl_swJZrvMdPBY7sw9yHt-8XyhEv1kiIdfUaGEw6H1KdTctThkPyHl_eE3H29_nX1nd3-_HZz9eWWOWlEZh1U28phAwY0eC06xwFl65quRiMqyY13quzZNbU2daO41l3HK2nQtdooJU_I2erdx_B79inbsU_ODwNOPszJinKAStY1lwX9_A_6EOZY_rtSShf5IuQr5WJIKfrO7mM_YjxYDnaJwK4R2BKBXSKwuvR8ejHPzejbvx1_bl4AsQKplKadj6-j_299BgTokSE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2015451554</pqid></control><display><type>article</type><title>Mortality among patients due to adverse drug reactions that lead to hospitalization: a meta-analysis</title><source>Springer Nature - Complete Springer Journals</source><creator>Patel, Tejas K. ; Patel, Parvati B.</creator><creatorcontrib>Patel, Tejas K. ; Patel, Parvati B.</creatorcontrib><description>Purpose
The aim of this study was to estimate the prevalence of mortality among patients due to adverse drug reactions that lead to hospitalisation (fatal ADR
Ad
), to explore the heterogeneity in its estimation through subgroup analysis of study characteristics, and to identify system-organ classes involved and causative drugs for fatal ADR
Ad
.
Methods
We identified prospective ADR
Ad
-related studies via screening of the PubMed and Google Scholar databases with appropriate key terms. We estimated the prevalence of fatal ADR
Ad
using a double arcsine method and explored heterogeneity using the following study characteristics: age groups, wards, study region, ADR definitions, ADR identification methods, study duration and sample size. We examined patterns of fatal ADR
Ad
and causative drugs.
Results
Among 312 full-text articles assessed, 49 studies satisfied the selection criteria and were included in the analysis. The mean prevalence of fatal ADR
Ad
was 0.20% (95% CI: 0.13–0.27%;
I
2
= 93%). The age groups and study wards were the important heterogeneity modifiers. The mean fatal ADR
Ad
prevalence varied from 0.01% in paediatric patients to 0.44% in the elderly. Subgroup analysis showed a higher prevalence of fatal ADR
Ad
in intensive care units, emergency departments, multispecialty wards and whole hospitals. Computer-based monitoring systems in combination with other methods detected higher mortality. Intracranial haemorrhage, renal failure and gastrointestinal bleeding accounted for more than 50% of fatal ADR
Ad
cases. Warfarin, aspirin, renin–angiotensin system (RAS) inhibitors and digoxin accounted for 60% of fatal ADR
Ad
.
Conclusions
ADR
Ad
is an important cause of mortality. Strategies targeting the safer use of warfarin, aspirin, RAS inhibitors and digoxin could reduce the large number of fatal ADR
Ad
cases.</description><identifier>ISSN: 0031-6970</identifier><identifier>EISSN: 1432-1041</identifier><identifier>DOI: 10.1007/s00228-018-2441-5</identifier><identifier>PMID: 29556685</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Angiotensin ; Aspirin ; Biomedical and Life Sciences ; Biomedicine ; Digoxin ; Emergency medical services ; Geriatrics ; Hemorrhage ; Heterogeneity ; Hospitalization ; Inhibitors ; Intensive care units ; Meta-analysis ; Mortality ; Older people ; Pharmacoepidemiology and Prescription ; Pharmacology/Toxicology ; Renal failure ; Renin ; Side effects ; Warfarin</subject><ispartof>European journal of clinical pharmacology, 2018-06, Vol.74 (6), p.819-832</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2018</rights><rights>European Journal of Clinical Pharmacology is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-f0868cab07050e52fc10a3dcbf9a728317ec4441fb9579b4155ff1837acd57443</citedby><cites>FETCH-LOGICAL-c372t-f0868cab07050e52fc10a3dcbf9a728317ec4441fb9579b4155ff1837acd57443</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00228-018-2441-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00228-018-2441-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,778,782,27911,27912,41475,42544,51306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29556685$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Patel, Tejas K.</creatorcontrib><creatorcontrib>Patel, Parvati B.</creatorcontrib><title>Mortality among patients due to adverse drug reactions that lead to hospitalization: a meta-analysis</title><title>European journal of clinical pharmacology</title><addtitle>Eur J Clin Pharmacol</addtitle><addtitle>Eur J Clin Pharmacol</addtitle><description>Purpose
The aim of this study was to estimate the prevalence of mortality among patients due to adverse drug reactions that lead to hospitalisation (fatal ADR
Ad
), to explore the heterogeneity in its estimation through subgroup analysis of study characteristics, and to identify system-organ classes involved and causative drugs for fatal ADR
Ad
.
Methods
We identified prospective ADR
Ad
-related studies via screening of the PubMed and Google Scholar databases with appropriate key terms. We estimated the prevalence of fatal ADR
Ad
using a double arcsine method and explored heterogeneity using the following study characteristics: age groups, wards, study region, ADR definitions, ADR identification methods, study duration and sample size. We examined patterns of fatal ADR
Ad
and causative drugs.
Results
Among 312 full-text articles assessed, 49 studies satisfied the selection criteria and were included in the analysis. The mean prevalence of fatal ADR
Ad
was 0.20% (95% CI: 0.13–0.27%;
I
2
= 93%). The age groups and study wards were the important heterogeneity modifiers. The mean fatal ADR
Ad
prevalence varied from 0.01% in paediatric patients to 0.44% in the elderly. Subgroup analysis showed a higher prevalence of fatal ADR
Ad
in intensive care units, emergency departments, multispecialty wards and whole hospitals. Computer-based monitoring systems in combination with other methods detected higher mortality. Intracranial haemorrhage, renal failure and gastrointestinal bleeding accounted for more than 50% of fatal ADR
Ad
cases. Warfarin, aspirin, renin–angiotensin system (RAS) inhibitors and digoxin accounted for 60% of fatal ADR
Ad
.
Conclusions
ADR
Ad
is an important cause of mortality. Strategies targeting the safer use of warfarin, aspirin, RAS inhibitors and digoxin could reduce the large number of fatal ADR
Ad
cases.</description><subject>Angiotensin</subject><subject>Aspirin</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Digoxin</subject><subject>Emergency medical services</subject><subject>Geriatrics</subject><subject>Hemorrhage</subject><subject>Heterogeneity</subject><subject>Hospitalization</subject><subject>Inhibitors</subject><subject>Intensive care units</subject><subject>Meta-analysis</subject><subject>Mortality</subject><subject>Older people</subject><subject>Pharmacoepidemiology and Prescription</subject><subject>Pharmacology/Toxicology</subject><subject>Renal failure</subject><subject>Renin</subject><subject>Side effects</subject><subject>Warfarin</subject><issn>0031-6970</issn><issn>1432-1041</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kU1r3DAQhkVpaLZJf0AvRdBLLkpGXys7txLSNpDSS3MWY1neONjWVpIDm18fGacNFHrSYZ55RjMvIR85nHMAc5EAhKgY8IoJpTjTb8iGKykYB8Xfkg2A5GxbGzgm71N6AOC6BvmOHIta6-220hvS_ggx49DnA8UxTDu6x9z7KSfazp7mQLF99DF52sZ5R6NHl_swJZrvMdPBY7sw9yHt-8XyhEv1kiIdfUaGEw6H1KdTctThkPyHl_eE3H29_nX1nd3-_HZz9eWWOWlEZh1U28phAwY0eC06xwFl65quRiMqyY13quzZNbU2daO41l3HK2nQtdooJU_I2erdx_B79inbsU_ODwNOPszJinKAStY1lwX9_A_6EOZY_rtSShf5IuQr5WJIKfrO7mM_YjxYDnaJwK4R2BKBXSKwuvR8ejHPzejbvx1_bl4AsQKplKadj6-j_299BgTokSE</recordid><startdate>20180601</startdate><enddate>20180601</enddate><creator>Patel, Tejas K.</creator><creator>Patel, Parvati B.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20180601</creationdate><title>Mortality among patients due to adverse drug reactions that lead to hospitalization: a meta-analysis</title><author>Patel, Tejas K. ; Patel, Parvati B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-f0868cab07050e52fc10a3dcbf9a728317ec4441fb9579b4155ff1837acd57443</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Angiotensin</topic><topic>Aspirin</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Digoxin</topic><topic>Emergency medical services</topic><topic>Geriatrics</topic><topic>Hemorrhage</topic><topic>Heterogeneity</topic><topic>Hospitalization</topic><topic>Inhibitors</topic><topic>Intensive care units</topic><topic>Meta-analysis</topic><topic>Mortality</topic><topic>Older people</topic><topic>Pharmacoepidemiology and Prescription</topic><topic>Pharmacology/Toxicology</topic><topic>Renal failure</topic><topic>Renin</topic><topic>Side effects</topic><topic>Warfarin</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Patel, Tejas K.</creatorcontrib><creatorcontrib>Patel, Parvati B.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of clinical pharmacology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Patel, Tejas K.</au><au>Patel, Parvati B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mortality among patients due to adverse drug reactions that lead to hospitalization: a meta-analysis</atitle><jtitle>European journal of clinical pharmacology</jtitle><stitle>Eur J Clin Pharmacol</stitle><addtitle>Eur J Clin Pharmacol</addtitle><date>2018-06-01</date><risdate>2018</risdate><volume>74</volume><issue>6</issue><spage>819</spage><epage>832</epage><pages>819-832</pages><issn>0031-6970</issn><eissn>1432-1041</eissn><abstract>Purpose
The aim of this study was to estimate the prevalence of mortality among patients due to adverse drug reactions that lead to hospitalisation (fatal ADR
Ad
), to explore the heterogeneity in its estimation through subgroup analysis of study characteristics, and to identify system-organ classes involved and causative drugs for fatal ADR
Ad
.
Methods
We identified prospective ADR
Ad
-related studies via screening of the PubMed and Google Scholar databases with appropriate key terms. We estimated the prevalence of fatal ADR
Ad
using a double arcsine method and explored heterogeneity using the following study characteristics: age groups, wards, study region, ADR definitions, ADR identification methods, study duration and sample size. We examined patterns of fatal ADR
Ad
and causative drugs.
Results
Among 312 full-text articles assessed, 49 studies satisfied the selection criteria and were included in the analysis. The mean prevalence of fatal ADR
Ad
was 0.20% (95% CI: 0.13–0.27%;
I
2
= 93%). The age groups and study wards were the important heterogeneity modifiers. The mean fatal ADR
Ad
prevalence varied from 0.01% in paediatric patients to 0.44% in the elderly. Subgroup analysis showed a higher prevalence of fatal ADR
Ad
in intensive care units, emergency departments, multispecialty wards and whole hospitals. Computer-based monitoring systems in combination with other methods detected higher mortality. Intracranial haemorrhage, renal failure and gastrointestinal bleeding accounted for more than 50% of fatal ADR
Ad
cases. Warfarin, aspirin, renin–angiotensin system (RAS) inhibitors and digoxin accounted for 60% of fatal ADR
Ad
.
Conclusions
ADR
Ad
is an important cause of mortality. Strategies targeting the safer use of warfarin, aspirin, RAS inhibitors and digoxin could reduce the large number of fatal ADR
Ad
cases.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>29556685</pmid><doi>10.1007/s00228-018-2441-5</doi><tpages>14</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0031-6970 |
| ispartof | European journal of clinical pharmacology, 2018-06, Vol.74 (6), p.819-832 |
| issn | 0031-6970 1432-1041 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2015839913 |
| source | Springer Nature - Complete Springer Journals |
| subjects | Angiotensin Aspirin Biomedical and Life Sciences Biomedicine Digoxin Emergency medical services Geriatrics Hemorrhage Heterogeneity Hospitalization Inhibitors Intensive care units Meta-analysis Mortality Older people Pharmacoepidemiology and Prescription Pharmacology/Toxicology Renal failure Renin Side effects Warfarin |
| title | Mortality among patients due to adverse drug reactions that lead to hospitalization: a meta-analysis |
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