Mortalidad hospitalaria asociada a medicamentos en un Servicio de Medicina Interna

• Pardo-Cabello, A.J. ^[3] ; Manzano-Gamero, V. ^[1] ; Del-Pozo, E. ^[2] ; Gómez-Jiménez, F.J. ^[2] ; Luna-del Castillo, J.D. ^[2] ; Puche-Cañas, E. ^[2]
  1. [1] Hospital Universitario Virgen de las Nieves

     Hospital Universitario Virgen de las Nieves

     Granada, España

     
  2. [2] Universidad de Granada

     Universidad de Granada

     Granada, España

     
  3. [3] Servicio de Medicina Interna. Hospital Clínico San Cecilio. Granada, España.

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• Localización: Anales del sistema sanitario de Navarra, ISSN 1137-6627, Vol. 41, Nº. 3, 2018, págs. 339-346
• Idioma: español
• DOI: 10.23938/ASSN.0381
• Títulos paralelos:
  • Drug-related mortality among inpatients admitted in Internal Medicine
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• Dialnet Métricas: 1 Cita
• Resumen
  • español

    Fundamento. Analizar la mortalidad asociada a fármacos, los medicamentos más implicados y los factores de riesgo asociados en pacientes ingresados en Medicina Interna.Material y métodos. Estudio retrospectivo, observacional. Se revisaron las historias clínicas de los adultos fallecidos consecutivamente en el servicio de Medicina Interna de un hospital universitario durante veintidós meses. La variable principal fue la mortalidad hospitalaria sospechosa de estar relacionada con medicamentos administrados durante el ingreso.Resultados. De las 455 muertes analizadas, el 22,2% estuvieron relacionadas con los medicamentos recibidos; en 55 casos (12,1%) los medicamentos fueron considerados sospechosos de ser la causa de la muerte y en 46 casos (10,1%) de contribuir a ello. Los diagnósticos más frecuentes en los casos de muerte asociada a medicamentos fueron arritmia cardiaca (23,7%), hemorragia grave (19,8%) y neumonía aspirativa (12,8%). Los medicamentos implicados con mayor prevalencia en las muertes relacionadas con el tratamiento farmacológico fueron los antitrombóticos (23,7 %), la digoxina (21,7 %), los antipsicóticos (17,8%) y las benzodiacepinas (14,8%). El único factor de riesgo independiente de mortalidad asociada a tratamiento fue el número de medicamentos administrados (OR=1,25; IC95%: 1,14-1,37). No se encontró asociación significativa con la edad, sexo, número de patologías o duración de la estancia hospitalaria.Conclusiones. Un alto porcentaje de las muertes de pacientes ingresados en Medicina Interna se consideran relacionadas con los medicamentos recibidos. Los antitrombóticos, digoxina y psicofármacos fueron los agentes más frecuentemente implicados. Dicha mortalidad se asocia de manera independiente y significativa con el número de medicamentos administrados. 

  • English

    Background. To analyze the mortality associated with prescriptions, the drugs most frequently involved and the associated risk factors in patients admitted to Internal Medicine.Methods. A retrospective, observational study. The clinical records of adult patients who died consecutively in the department of Internal Medicine in a Spanish tertiary hospital over twenty-two months were reviewed. The main variable was the prevalence of hospital death suspected of being related to the medications administered during admission.Results. Out of the 455 deaths analyzed, 22.2% were related to the medications received; in 55 cases (12.1%) the drugs were suspected of being the cause of death and in 46 cases (10.1%) of contributing to it. The most frequent diagnoses in cases of death associated with drugs were cardiac arrhythmia (23.7%), severe hemorrhage (19.8%) and aspiration pneumonia (12.8%). The drugs with the highest prevalence in deaths related to pharmacological treatment were antithrombotic drugs (23.7%), digoxin (21.7%), antipsychotics (17.8%) and benzodiazepines (14.8%). The only independent risk factor for mortality associated with treatment was the number of medications administered (OR=1.25, 95%CI: 1.14-1.37). No significant association was found with age, sex, number of pathologies or duration of hospital stay.Conclusion. A high percentage of deaths of patients admitted to Internal Medicine were considered related to the medications received. Antithrombotic drugs, digoxin and psychotropic drugs were the agents most frequently implicated. This mortality is independently and significantly associated with the number of medications administered.

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