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Table 4 Adverse drug events (ADEs) as cause of Emergency Department (ED) visits

From: Characterization and preventability of adverse drug events as cause of emergency department visits: a prospective 1-year observational study

ADEs a

No. of Cases (%)

No. of preventable Cases (%)

Most frequent drug classes

(No. of Cases)b

Mild allergic reactionc

214 (37.2)

1 (1.4)

Antibiotics (116), anti-inflammatory/antirheumatic drugs (55)

Moderate to severe allergic reactiond

154 (26.8)

6 (8.5)

Antibiotics (64), anti-inflammatory/antirheumatic drugs (52)

Moderate to severe neurological effecte

30 (5.2)

12 (16.9)

Psycholeptics (12), antiepileptics (7)

Mild neurological effectf

29 (5.0)

10 (14.1)

Psycholeptics (8), analgesics (6)

Gastrointestinal disturbanceg

27 (4.7)

9 (12.7)

Anti-inflammatory/antirheumatic drugs (10), hRAS-acting agents (3), antibiotics (3), antineoplastic agents (3)

Haemorrhage

21 (3.7)

4 (5.6)

 

- Major haemorrhage (i.e. gastrointestinal or pulmonary haemorrhage)

4 (0.7)

1 (1.4)

Antithrombotics (2), RAS-acting agents (1), antianemic preparations (1), beta-blocking agents (1), lipid modifying agents (1), anti-gout preparations (1)

- Minor bleeding (e.g. epistaxis, gingival or conjunctival haemorrhage)

17 (3.0)

3 (4.2)

Antithrombotics (15), lipid modifying agents (1), anti-inflammatory/antirheumatic drugs (1)

Rhythm disorder (e.g. bradycardia, tachycardia, palpitations, atrial fibrillation)

16 (2.9)

3 (4.2)

Cardiac therapy (8), RAS-acting agents (4)

Blood pressure disorder (i.e. hypotension, hypertension)

12 (2.1)

3 (4.2)

Antibiotics (3), cardiac therapy (3), psycholeptics (2), antihypertensives (2), beta blocking agents (2)

Suicide attempt

12 (2.1)

12 (16.9)

Psycholeptics (7), antiepileptics (3), psychoanaleptics (2)

Respiratory distress (e.g. respiratory depression, dyspnoea, desaturation)

7 (1.2)

2 (2.8)

Psycholeptics (4), antibiotics (2)

Hematologic disorder (e.g. anemia, leucopenia, thrombocytopenia)

7 (1.2)

–

Antithrombotics (2), psychoanaleptics (2)

Hyperglycemia

7 (1.2)

3 (4.2)

Anti-diabetes agents (3), corticosteroids for systemic use (2)

Acute renal failure

5 (0.9)

–

Diuretics (3), anti-diabetes agents (2)

Behavioural psychiatric disorder (e.g. anxiety, stupor, aggression)

4 (0.7)

3 (4.2)

Anti-inflammatory/antirheumatic drugs (1), analgesics (1), psycholeptics (1), anti-Parkinson (1)

Rhabdomyolysis

4 (0.7)

–

Antiepileptics (2), RAS-acting agents (1), lipid modifying agents (1), psychoanaleptics (1)

Subcutaneous abscess

4 (0.7)

–

Antibiotics (4)

Pancreatitis

3 (0.5)

1 (1.4)

Antiacid drugs (1), antibiotics (1), anti-inflammatory/antirheumatic drugs (1), calcium channel blockers (1), corticosteroids for systemic use (1), immunosuppressants (1), drugs for bone diseases (1)

Hypoglycaemia

3 (0.5)

2 (2.8)

Anti-diabetes agents (3)

Other effecti

16 (2.9)

–

RAS-acting agents (4), psycholeptics (3), diuretics (2), anti-diabetes agents (2), psychoanaleptics (2)

  1. aCases were classified by ED physician-developed primary diagnosis and grouped as published in NEISS-CADES analysis. Primary diagnoses are mutually exclusive. For example, an ED visit in which a patient experienced both erythema, dermatitis, pruritus would be categorized as mild allergic reactions; an ED visit in which a patient experienced both vomiting and abdominal pain would be categorized as gastrointestinal disturbance
  2. bWe have considered only the principal involved drug categories, for each primary diagnosis. In most cases more drug categories were simultaneously involved
  3. cErythema, urticaria, dermatitis, rash, localized or peripheral edema, flushing, pruritus, esanthema
  4. dAnaphylaxis, angioedema, facial edema, pharyngeal edema, laryngeal edema, labial edema, eyelid edema, orbital edema, vasculitis, hyperhidrosis, drug hypersensitivity, allergy-related respiratory compromise (dyspnoea, bronchospasm, throat tightness, tachypnea, hyperventilation)
  5. eComa, panic attack, limbs paralysis, cranial traumatism, epilepsy, extrapyramidal disorder, loss of consciousness, headache, syncope, altered mental status
  6. fLethargy, fatigue, drowsiness, asthenia, hypoesthesia, paresthesia, tremor, vertigo
  7. gNausea, vomiting, abdominal pain, epigastric pain, ulcer, erosive gastropathy
  8. hRAS-acting agents, agents acting on the renin-angiotensin system
  9. iLactic acidosis (2), limbs phlebitis (2), hypertransaminasemia (2), heart failure (2), dystonia (2), arthralgia (2), jaundice (1), venous sinus thrombosis (1), anemia and peripheral edema (1), conjunctival haemorrhage and epilepsy (1), conjunctival haemorrhage and hypertension (1)