title: Influence of adverse drug events on morbidity and mortality in intensive care units: the JADE study.
abstract: OBJECTIVE
  To identify the influence of adverse drug events (ADEs) on morbidity and mortality in intensive care units (ICUs).
  
  
  METHODS
  A prospective cohort study.
  
  
  METHODS
  ICU setting at three acute care hospitals in Japan.
  
  
  METHODS
  All patients aged ≥15 years were admitted to all ICUs during a 6-month study period.
  
  
  METHODS
  No intervention.
  
  
  METHODS
  Mortality in the ICUs and the length of the ICU stay. .
  
  
  RESULTS
  We included 459 patients with a total of 3231 patient-days. Ninety-nine ADEs occurred in 70 patients (15%), so that the incidence of ADEs was 30.6 per 1000 patient-days and 21.6 ADEs per 100 admissions. Seventy-three patients (16%) died during their ICU stay. Excluding 38 deaths within 3 days after admission, 12 patients (17%) died among the 70 patients who had at least one ADE during their ICU stay and 23 (7%) died among 351 without an ADE (P = 0.003). The median ICU length of stay was 3 days. Excluding 73 patients who died during their ICU stay, the median ICU stay of patients with at least one ADE was 13 days, while it was only 2 days in the remainder (P < 0.0001). ADEs were associated with longer length of ICU stay but not with mortality even after adjusting for patients' severity of illness.
  
  
  CONCLUSIONS
  ADEs were common in ICUs and significantly associated with longer length of ICU stay but did not influence on mortality.
authors.affiliation: Division of General Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Ohta
authors.affiliation: Division of General Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Mio
authors.initials: M
authors.lastname: Sakuma
authors.affiliation: Department of Primary Care and Emergency Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Koike
authors.affiliation: Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA Department of Health Policy and Management, Harvard School of Public Health, Boston, MA, USA.
authors.forename: David W
authors.initials: DW
authors.lastname: Bates
authors.affiliation: Division of General Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Morimoto
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007564:Japan; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011787:Quality of Health Care; D012737:Sex Factors
keywords: adverse drug events; and patient safety; epidemiology; intensive care unit; length of ICU stay; mortality