Adverse drug events in trauma patients.
BACKGROUND
Adverse drug events (ADEs) are noxious and unintended results of drug therapy. ADEs have been shown to be a risk to hospitalized patients. The purpose of this study was to determine the rate and nature of ADEs in trauma patients and to characterize the population at risk.


METHODS
An electronic medical record, a hospital wide computerized surveillance program, and a clinical pharmacist prospectively investigated ADEs in 4,320 trauma patients from 1996 through 1999.


RESULTS
The rate of ADEs in trauma patients (98/4320, 2.3%) was twice that of non-trauma hospital patients (1,111/96,218, 1.2%, p < 0.001). Traumatized females had ADEs 1.5 times more often than traumatized males (2.7% versus 1.8%, p = 0.052). The medication class most often associated with ADEs was analgesics with 54% involving morphine and 20% involving meperidine. The most common ADEs were nausea, vomiting, and itching. Only one ADE was directly attributed to a medical error.


CONCLUSIONS
Trauma patients are at double the risk for ADEs. Analgesics are particularly associated with ADEs and use should be carefully monitored.
Lazarus
Harrison M
HM
Division of Trauma Services, LDS Hospital, Salt Lake City, Utah 84143, USA.
Fox
Jolene
J
Evans
R Scott
RS
Lloyd
James F
JF
Pombo
David J
DJ
Burke
John P
JP
Handrahan
Diana
D
Egger
Marlene J
MJ
Allen
Todd L
TL
Stevens
Mark H
MH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000009:adverse effects*; D002648:Child; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008500:Medical Records Department, Hospital / Q000458:organization & administration; D008614:Meperidine / Q000009:adverse effects; D008875:Middle Aged; D009020:Morphine / Q000009:adverse effects; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D014589:Utah; D014947:Wounds and Injuries / Q000188:drug therapy*
D000700:Analgesics; D009020:Morphine; D008614:Meperidine