Adverse drug events in critically ill patients with cancer: incidence, characteristics, and outcomes

J Pharm Pract. 2014 Apr;27(2):208-13. doi: 10.1177/0897190013513302. Epub 2013 Dec 6.

Abstract

Objective: To determine the incidence, characteristics, and outcomes of adverse drug events (ADEs) in critically ill patients with cancer.

Methods: This was a 5-month prospective observational study. Patients who were admitted to the adult medical/surgical oncology intensive care unit (ICU) were evaluated for any drug-related adverse events during their ICU stay. An ADE was defined as injury or patient harm resulting from medical intervention related to a drug.

Results: The incidence rate of ADEs was 96.5 per 1000 patient days and 35.3 per 100 ICU admissions. Of the reported ADEs, 57 (64.8%) were serious/life threatening, 30 (34.1%) were significant, 1 (1.1%) was fatal, and 14 (15.9%) of all ADEs were considered preventable. The most common drug classes associated with ADEs were antidiabetics, antibiotics, and analgesics/sedatives. The length of stay and presence of renal or respiratory failure were significantly associated with an increased number of ADEs. The length of stay and female sex were significantly associated with the likelihood of developing an ADE.

Conclusion: Critically ill patients with cancer are at high risk of developing ADEs. Strategies that reduce the incidence and severity of ADEs are essential to improve the outcomes of this patient population.

Keywords: adverse drug event; cancer; characteristics; incidence; intensive care unit.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / adverse effects
  • Critical Illness / epidemiology*
  • Critical Illness / therapy*
  • Drug-Related Side Effects and Adverse Reactions / diagnosis*
  • Drug-Related Side Effects and Adverse Reactions / epidemiology*
  • Drug-Related Side Effects and Adverse Reactions / prevention & control
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Neoplasms / drug therapy*
  • Neoplasms / epidemiology*
  • Prospective Studies
  • Treatment Outcome

Substances

  • Antineoplastic Agents