title: [Adverse drug reactions as cause of visit to the emergency department: incidence, features and outcomes].
abstract: The aim of the study was to determine incidence, features and outcomes of the adverse drug reactions (ADR) among emergency department (ED) visits of S. Giovanni Battista Hospital in Turin. We evaluated 16.055 patients among ED visits in a period of five months; the mean age was 59.6 +/- 20.2 year (range 17-93 y; 8.054 women and 8.001 men); 426 (2.6%) had ADRs, and 91 (21.4%) were admitted to the hospital. In multivariate analysis only the number of medicines was positive correlated with ADR. The drugs most frequently ADR-related were: anticoagulants (21.8%), antibiotics (17.6%), NSAIDs (9.9%), hypoglycaemic agents (9.6%), ACE-inhibitors (4.7%), antipyretics (4%) and alfa-litics (3.3%); the most common clinic events were: gastrointestinal bleeding (21.1%), rash (19.7%), confusion (23.9%), hypoglycaemia (8.4%), dyspnoea (7.0%), syncope and wheezing (5.6%), gastrointestinal bleeding (2.8%), anaemia (2.8%), haematomas (4.2%), vomiting (4.2%). Factor associated with increased ADR-hospital admission were increasing age (over 65 years old), gastrointestinal diseases, dementia and ADL-dependence. ADR-patients' Emergency Department mortality was higher than noADR-patients' one. The mean duration of hospitalization was higher in ADR-patients. It is necessary to reduce the number of drugs and improve studies and prevention strategies targeted to reduce the impact of ADR, specially in the elderly population.
authors.affiliation: Sezione di Geriatria, Dipartimento di Discipline Medico-Chirurgiche, Università, Torino.
authors.forename: Mauro
authors.initials: M
authors.lastname: Zanocchi
authors.forename: Vittoria
authors.initials: V
authors.lastname: Tibaldi
authors.forename: Dario
authors.initials: D
authors.lastname: Amati
authors.forename: Federica
authors.initials: F
authors.lastname: Francisetti
authors.forename: Elisa
authors.initials: E
authors.lastname: Martinelli
authors.forename: Mafalda
authors.initials: M
authors.lastname: Gonella
authors.forename: Flavio
authors.initials: F
authors.lastname: Cerrato
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Ponte
authors.forename: Angela
authors.initials: A
authors.lastname: Luppino
authors.forename: Benedetta
authors.initials: B
authors.lastname: Bardelli
authors.forename: Antonella
authors.initials: A
authors.lastname: Canadè
authors.forename: Federico
authors.initials: F
authors.lastname: Gariglio
authors.forename: Corrado
authors.initials: C
authors.lastname: Moiraghi
authors.forename: Mario
authors.initials: M
authors.lastname: Molaschi
mesh_terms: D000328:Adult; D016907:Adverse Drug Reaction Reporting Systems; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D000925:Anticoagulants / Q000009:adverse effects; D003221:Confusion / Q000139:chemically induced; D003875:Drug Eruptions / Q000209:etiology; D064420:Drug-Related Side Effects and Adverse Reactions; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016896:Treatment Outcome
chemical_list: D018712:Analgesics, Non-Narcotic; D000806:Angiotensin-Converting Enzyme Inhibitors; D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000925:Anticoagulants; D007004:Hypoglycemic Agents