Monitoring abnormal laboratory values as antecedents to drug-induced injury

J Trauma. 2005 Dec;59(6):1457-62. doi: 10.1097/01.ta.0000196009.42623.50.

Abstract

Background: Clinical abnormalities associated with drug therapy may lead to injury if untreated. Detection of preceding drug-related hazardous conditions (DRHCs) may provide the opportunity to prevent injury. This study evaluated the frequency of abnormal laboratory values attributed to the effect of drugs.

Methods: A total of 590 patients consecutively admitted to a surgical intensive care unit during a 3-month period were prospectively studied. Serum electrolyte, platelet, creatinine, glucose, magnesium, and liver enzyme concentrations were classified as either normal or abnormal using standard criteria. DRHCs were abnormal laboratory results determined to be caused by drugs.

Results: DRHCs were detected in 16.4% of patients, reflecting a rate of 47 events per 1,000 patient days. 66%, 22%, and 12% of DRHCs were categorized as either definite, probable, or possible, respectively. In 97% of suspected DRHCs, clinicians responded by ordering additional laboratory tests or changing drug regimens.

Conclusions: Monitoring laboratory values and assessing the association to medications may reduce the risk of injury consequent to adverse drug events.

MeSH terms

  • Adult
  • Aged
  • Blood Glucose / metabolism*
  • Creatinine / blood*
  • Critical Care
  • Drug-Related Side Effects and Adverse Reactions / blood*
  • Electrolytes / blood*
  • Female
  • Humans
  • Liver / enzymology*
  • Male
  • Middle Aged
  • Platelet Count*
  • Prospective Studies

Substances

  • Blood Glucose
  • Electrolytes
  • Creatinine