Prevalence and characteristics of adverse drug reactions in neurosurgical intensive care patients.
OBJECTIVE
To evaluate the prevalence and characteristics of adverse drug reactions (ADRs) in neurosurgical intensive care patients.


METHODS
Retrospective analysis of ADR data obtained from a spontaneous reporting system in a tertiary care university hospital. Reports of suspected ADRs in adult patients admitted emergently or electively to the neurosurgical service were included.


RESULTS
Over the 3 year period, 3496 neurosurgical intensive care unit (ICU) patient admissions accounted for 5% of all hospital admissions. A total of 10% of all neurosurgical patients developed a suspected ADR, with three patients experiencing multiple reactions. Other adult ICU patients developed ADRs at a comparable rate (9%, P > 0.05). Overall, neurosurgery patients accounted for 12% of all spontaneously reported ADRs. Preventable reactions were observed in 43 (13%) cases, and treatment was required for 76%. The majority (96%) of ADRs resolved or improved at the time of the ADR report. Nausea, pruritus, thrombocytopenia, and vomiting were most frequently noted. Therapies most often associated with reported events were analgesics, antipyretics, antibiotics, anticonvulsants, and histamine H2 antagonists. The relationship between central nervous system disease and adverse event occurrence is not clear.


CONCLUSIONS
Despite the narrow scope of drug regimens in neurosurgical ICU patients, ADRs can complicate therapy in this critically ill population. Neurosurgical ICU patients seem to experience ADRs no more frequently than their adult ICU counterparts.
Smith
Kelly M
KM
University of Kentucky College of Pharmacy, Lexington, Kentucky 40536-0293, USA.
Jeske
Chad S
CS
Young
Byron
B
Hatton
Jimmi
J
D000328:Adult; D016907:Adverse Drug Reaction Reporting Systems; D000700:Analgesics / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D009325:Nausea / Q000139:chemically induced; D009493:Neurosurgery / Q000379:methods; D015995:Prevalence; D011537:Pruritus / Q000139:chemically induced; D012189:Retrospective Studies
D000700:Analgesics; D000900:Anti-Bacterial Agents