Verapamil administration to patients with contraindications: is it associated with adverse outcomes?
OBJECTIVE
To determine if the use of verapamil in patients with contraindications is associated with adverse sequelae, thereby assessing whether process measures of the quality of care are correlated with patient outcomes.


METHODS
Retrospective chart review comparing the incidence of adverse outcomes and drug failure in patients with and without contraindications to verapamil administration.


METHODS
University hospital emergency department.


METHODS
All patients more than 12 years old who received IV verapamil during the study period.


METHODS
The presence or absence of contraindications to verapamil, the occurrence of complications, and the frequency of drug failure were determined by chart review.


RESULTS
Patients with contraindications to verapamil experienced a significantly higher incidence of adverse outcomes and drug failures than those without contraindications. The presence of contraindicated rhythms, low pretreatment blood pressure, and signs of congestive heart failure were each specifically associated with an increased risk of adverse sequelae.


CONCLUSIONS
Verapamil should not be administered to patients with contraindications to its use. In this instance, quality assurance process measures correlate with patient outcomes.
Flinder Medical Centre, Bedford Park, South Australia.
M
M
Kuhn
D L
DL
Schriger
D000328:Adult; D000075202:Contraindications; D004630:Emergencies; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014700:Verapamil / Q000009:adverse effects
D014700:Verapamil