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Drug-related mortality among inpatients: a retrospective observational study

  • Pharmacoepidemiology and Prescription
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Abstract

Purpose

Hospital mortality related to adverse drug reactions (ADRs) is a relevant clinical problem with major health and economic consequences. We conducted a study to assess hospital mortality related to ADRs, the drugs most frequently involved, and the possible risk factors associated with fatal ADRs.

Methods

A retrospective observational study was conducted, reviewing the clinical records of 1388 consecutive adult patients (18–101 years) who died during a 22-month period in a tertiary hospital in Southern Europe (Granada, Spain). The main outcome was the prevalence of hospital death suspected to be related to administered drugs.

Results

Out of the 1388 adult deaths studied, 256 (18.4 %) were suspected of being related to drugs. Drugs were suspected of causing death in 146 inpatients (10.5 %) and contributing to death in 110 (7.9 %). Drugs related to death were administered during the hospital stay in 161 cases (11.5 %) and before hospital admission in 95 (6.84 %). The most frequent fatal ADRs were cardiac arrhythmia, gastrointestinal bleeding, and respiratory failure. The drugs most frequently involved in fatal ADRs were antithrombotics (anticoagulants or antiplatelets) (23 %), psychotropic drugs (21.2 %), and digoxin (11.3 %). Independent risk factors for ADR-related death were the presence of ≥4 diseases (OR = 1.43) and the receipt of ≥10 drugs (OR = 3.24), but no significant association with gender or age was found.

Conclusions

A high percentage of hospital deaths were suspected of being associated with ADRs, especially in patients with comorbidity and/or polypharmacy. Antithrombotics, psychotropics, and digoxin were the drugs most frequently associated with in-hospital drug-related deaths.

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Acknowledgments

The authors are grateful to Eloísa Casado Fernández MD and Carmen Laraño Díaz MD of the Clinical Documentation Department of San Cecilio University Hospital of Granada (Spain) and to Ana García Velasco and María Soriano Segura, research fellows of the School of Medicine of the University of Granada (Spain), for their participation in the gathering and coding of the data. The authors thank Richard Davies for improving the English style.

Authors contributions

Dr. AJ Pardo Cabello performed research, analyzed data and wrote the paper. Dr. E Del Pozo Gavilán performed research, analyzed data and wrote the paper. Dr. FJ Gómez Jiménez performed research, analyzed data and wrote the paper. Dr. C Mota Rodríguez performed research. Dr. JD Luna del Castillo analyzed data. Dr. E Puche Cañas conceived and designed study, performed research, analyzed data and wrote the paper.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, San Cecilio University Hospital, Avda. Dr. Olóriz n°16, 18012, Granada, Spain

    Alfredo José Pardo Cabello

  2. Department of Pharmacology, School of Medicine, Biomedical Research Institute ibs. Granada, University of Granada, Granada, Spain

    Esperanza Del Pozo Gavilán

  3. Department of Medicine, School of Medicine, University of Granada, Granada, Spain

    Francisco Javier Gómez Jiménez

  4. School of Health Sciences of the University of Granada, Granada, Spain

    Carmen Mota Rodríguez

  5. Department of Biostatistics, School of Medicine, University of Granada, Granada, Spain

    Juan de Dios Luna Del Castillo

  6. Clinical Pharmacology Unit of San Cecilio University Hospital, Granada, Spain

    Emilio Puche Cañas

  7. Department of Pharmacology of School of Medicine, University of Granada, Granada, Spain

    Emilio Puche Cañas

Authors
  1. Alfredo José Pardo Cabello
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  2. Esperanza Del Pozo Gavilán
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  3. Francisco Javier Gómez Jiménez
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  4. Carmen Mota Rodríguez
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  5. Juan de Dios Luna Del Castillo
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  6. Emilio Puche Cañas
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Corresponding author

Correspondence to Alfredo José Pardo Cabello.

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Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional research committee. Formal consent is not required for this retrospective study.

Funding

This study was funded by Department of Pharmacology (CP-2), University of Granada (Spain) in manuscript preparation.

Conflict of interest

The authors declare that they have no conflict of interest.

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Pardo Cabello, A., Del Pozo Gavilán, E., Gómez Jiménez, F. et al. Drug-related mortality among inpatients: a retrospective observational study. Eur J Clin Pharmacol 72, 731–736 (2016). https://doi.org/10.1007/s00228-016-2026-0

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  • DOI: https://doi.org/10.1007/s00228-016-2026-0

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