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Drug‐Related Inadvertent Deaths in a University Hospital – A Declining Trend
Author(s) -
LapattoReiniluoto Outi,
Patinen Laura,
Niemi Mikko,
Backman Janne T.,
Neuvonen Pertti J.
Publication year - 2015
Publication title -
basic and clinical pharmacology and toxicology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.805
H-Index - 90
eISSN - 1742-7843
pISSN - 1742-7835
DOI - 10.1111/bcpt.12435
Subject(s) - medicine , incidence (geometry) , drug reaction , pediatrics , drug , adverse drug reaction , emergency medicine , pharmacology , physics , optics
We studied the incidence of fatal adverse drug reactions ( ADR s) in a tertiary hospital to find out which drugs were involved. The secondary objective was to compare the data from the same hospital published 12 years earlier. All 1708 death cases in the H elsinki U niversity C entral H ospital during the year 2012 were retrospectively evaluated. All suspected drug‐related deaths, excluding suicides, were scrutinized by an expert panel using the WHO ADR probability classification. Of all cases, 52 (3.0%) were classified as certainly or probably drug related and 24 (1.4%) as possibly drug related. Together, these corresponded to 0.02% of all hospital admissions. The most commonly involved drugs in certain or probable cases were cytostatics (18 cases, 1.1% of all cases) and antithrombotics (17, 1.0%). Twelve years earlier, these caused 27 (1.8%) and 22 (1.5%) cases, respectively. Non‐steroidal anti‐inflammatory drugs ( NSAID s) and glucocorticoids caused less (2 and 0 cases) fatal ADR s than earlier (12 and 4 cases, p = 0.048 and p = 0.005, respectively). Most of the ADR s leading to death were present already in admission and affected seriously ill or elderly patients. Hospital‐born fatal ADR s occurred in 0.003% of patients. In conclusion, cytostatics and antithrombotics are still the leading causes of fatal ADR s, but NSAID s and glucocorticoids seem to cause fatal ADR s less often than previously. The incidence of fatal ADR s in 2012 was 3.0% of all deaths, suggesting a decline compared to the 2000 value (5.0%). Improved awareness, prevention and treatment of ADR s and safer medicines may explain these declining trends.