[Medicinal iatrogenics in hospitals. A survey on a given day].
OBJECTIVE
Medicinal iatrogenics are responsible for hospital admissions but also occur in hospitals. In view of the lack of knowledge, prevalence and nature of the adverse drug-related events (ADE) in the Bichat-Claude Bernard hospital group in Paris, and because of the potential severity of the latter, the Local drug committee has decided to develop a policy to manage these risks.


METHODS
The first stage consisted in a transversal study on a given day in the departments in which patients are hospitalised for more than 24 hours, in order to assess the prevalence, severity and preventability of ADE and to search for factors of risk.


RESULTS
107 ADE were observed in 89 patients on the day of the survey (9.9% global prevalence of ADE [CI 95%: 8.8% - 11.0%]). Among the latter, 57 patients had exhibited at least one adverse event during their hospitalisation, i.e., a prevalence of 6.3% ([CI 95%: 4.7% - 7.9%] ). Two thirds of these patients were hospitalised in medical departments. These nosocomial ADE (nosocomial adverse drug events) were serious or severe in 73% of cases and 25% could have been avoided. The only clearly identified risk factor was the number of drugs prescribed.


CONCLUSIONS
This review has drawn the attention of the medical and paramedical community to the need to define vigilance markers, and has provided some elements of response that should be further completed by a prospective cohort study.
Baune
B
B
Groupe de travail du Comité local du médicament, Groupe hospitalier Bichat-Claude Bernard, Paris.
Kessler
V
V
Patris
S
S
Descamps
V
V
Casalino
E
E
Quenon
J-L
JL
Farinotti
R
R
D000328:Adult; D016907:Adverse Drug Reaction Reporting Systems; D000368:Aged; D003625:Data Collection; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006760:Hospitalization; D006761:Hospitals; D006801:Humans; D007049:Iatrogenic Disease; D007902:Length of Stay; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D010297:Paris; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors