title: Adverse drug reactions (ADRs) associated with hospital admissions - elderly female patients are at highest risk.
abstract: BACKGROUND
  ADRs represent a significant problem in drug utilisation. The prevalence of admissions caused by ADRs varies depending on the observational site, studied population, data collection method and the used definitions. Women seem to be more frequently affected than men.
  
  
  OBJECTIVE
  To assess the incidence and quality of ADRs related to hospital admissions, to identify the drugs most commonly involved and to define risk factors and preventive strategies for those ADRs.
  
  
  METHODS
  3,190 medical records of all newly admitted internal ward patients were assessed in a prospective observational study in an internal hospital over 6 months. Potential ADRs at hospital admission were identified following a list of suspicious symptoms and laboratory results. Cases were evaluated by means of a computer tool and data-base specialized on detecting causality and severity of ADRs.
  
  
  RESULTS
  304 ADRs were identified in 242 patients (7.6%), with 60% directly leading to admission. More women than men encountered an ADR (10 vs. 6%, p < 0.005). Analyzed separately by age groups, this gender difference became significant at an age of ≥ 81 years. The most common ADRs were electrolyte imbalances and over-anticoagulation. Diuretics and vitamin K antagonists were significantly correlated with ADRs. 62% of all ADRs were severe or life-threatening.
  
  
  CONCLUSIONS
  ADRs leading or related to hospital admission are highly prevalent. Older age and female gender are significantly associated with ADR related hospital admissions. Causative drugs are the ones prescribed most frequently. Multidisciplinary preventive strategies and surveillance methods are necessary to ensure better care and patient safety especially for elderly women.
authors.affiliation: Pharmacy Department, Landesapotheke Salzburg, Germany. c.dueckelmann@salk.at
authors.forename: C
authors.initials: C
authors.lastname: Hofer-Dueckelmann
authors.forename: E
authors.initials: E
authors.lastname: Prinz
authors.forename: W
authors.initials: W
authors.lastname: Beindl
authors.forename: J
authors.initials: J
authors.lastname: Szymanski
authors.forename: G
authors.initials: G
authors.lastname: Fellhofer
authors.forename: M
authors.initials: M
authors.lastname: Pichler
authors.forename: J
authors.initials: J
authors.lastname: Schuler
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004347:Drug Interactions; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D012306:Risk; D012727:Sex Characteristics