Resultados negativos asociados al uso de medicamentos que motivan ingreso hospitalario / Adverse Drug Reactions Which Provoke Hospital Admission

Objetivo Identificar, clasificar y cuantificar la frecuencia de los resultados clínicos negativos asociados al uso de medicamentos (RNM) como motivo de ingreso hospitalario desde el servicio de urgencias (SU). Determinar el carácter prevenible de los RNM, identificar factores que predisponen al ingreso por RNM, determinar los costes asociados y conocer qué medicamentos se ven implicados con mayor frecuencia. Método Estudio transversal, prospectivo y observacional en pacientes que ingresaban desde el SU. Se aplicó el método Dáder para la detección de RNM. Los RNM se clasificaron según el Tercer Consenso de Granada, la evitabilidad se determinó aplicando el algoritmo de Schumock y Thornton, modificado por Otero et al y la gravedad según Schneider. Para el estudio económico se consideraron los costes directos generados durante el ingreso. Se analizó la asociación entre los RNM y edad, sexo, insuficiencia renal y hepática, y consumo de medicamentos. Se utilizó la regresión logística múltiple para identificar los factores de riesgo. Resultados El 19,4% de los ingresos fueron consecuencia directa de RNM, siendo evitables el 65%. El grupo de terapia antineoplásica e inmunosupresores causó el 38% de los RNM. El 20,4% de los ingresos requirieron traslado a la UCI o provocaron daño permanente. Se encontró una asociación estadísticamente significativa entre los RNM y los pacientes en tratamiento con terapia hormonal, fármacos de «alto riesgo» o ingresados en el servicio de endocrinología. El gasto ocasionado por los RNM fue de 237.377 € (AU)

Objective To identify, classify and quantify the frequency of negative clinical adverse drug reactions (ADR) resulting in hospital admission from the emergency department (ED). To determine ADR preventability, identify ADR-related admission factors, calculate related costs and recognise which drugs are the most often involved. Method Cross-sectional, prospective and observational study of patients who were admitted to hospital from the ED. We used the Dader method to detect ADR. We classified ADR in accordance with the Tercer Consenso de Granada (third Granada consensus), and calculated ADR preventability using the Schumock and Thornton scales (modified by Otero et al.), and ADR severity according to Schneider. We considered the direct costs generated during the hospital stay for the economic study. We analysed the correlation between ADR and age, sex, kidney and liver failure, and drug use. We used multiple logistic regression analysis to identify risk factors.Results19.4% of admissions were the direct consequence of ADR, 65% of which were preventable. Antineoplastic therapy and immunosupressants caused 38% of ADR. 20.4% of admissions had to be transferred to the intensive care unit (ICU) or caused permanent damage. We found statistical significance between ADR and patients undergoing hormonal therapy, ‘high risk’ drugs and those admitted to the endocrinology department. The ADR-associated cost was €237,377.ConclusionsADR-related admission is a problem with a high prevalence, and most cases are preventable (AU)

Adverse drug reactions which provoke hospital admission.

OBJECTIVE: To identify, classify and quantify the frequency of negative clinical adverse drug reactions (ADR) resulting in hospital admission from the emergency department (ED). To determine ADR preventability, identify ADR-related admission factors, calculate related costs and recognise which drugs are the most often involved. METHOD: Cross-sectional, prospective and observational study of patients that were admitted to hospital from the ED. We used the Dader method to detect ADR. We classified ADR in accordance with the Tercer Consenso de Granada (third Granada consensus), and calculated ADR preventability using the Schumock and Thornton scales (modified by Otero et al), and ADR severity according to Schneider. We considered the direct costs generated during the hospital stay for the economic study. We analysed the correlation between ADR and age, sex, kidney and liver failure, and drug use. We used multiple logistic regression analysis to identify risk factors. RESULTS: 19.4% of admissions were the direct consequence of ADR, 65% of which were preventable. Antineoplastic therapy and immunosuppressants caused 38% of ADR. 20.4% of admissions had to be transferred to the intensive care unit (ICU) or caused permanent damage. We found statistical significance between ADR and patients undergoing hormonal therapy, 'high risk' drugs and those admitted to the endocrinology department. The ADR-associated cost was €237,377. CONCLUSIONS: ADR-related admission is a problem with a high prevalence, and most cases are preventable.

Superoxidase dismutase (SOD) topical use in oncologic patients: treatment of acute cutaneous toxicity secondary to radiotherapy

OBJECTIVE: The objective of this study is to evaluate the efficiency of SOD applied topically in oncologic patients affected by acute radiodermatitis. MATERIALS AND METHOD: This study includes 57 patients who showed a dermatitis grade 2 or superior; they were administered SOD ointment b.i.d. (40 mg, weekly) and follow-up continued for 12 weeks. RESULTS: At the end of radiotherapy, 77.1% of the patients ameliorated completely or partially, and at the end of the 12-week period 100% of patients were free of toxicity. No acute toxicity relapses were reported. Response time reduced during radiotherapy, as well as the treatment time at the end of it. CONCLUSIONS: The employment of SOD topically is efficient in the treatment of radiodermatitis, which is an acute side effect of radiotherapy (AU)

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