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Medical Forum / General / General / January 2006Incidence of Adverse Drug Reactions in Hospitalized Patients
A Meta-analysis of Prospective Studies Jason Lazarou, MSc; Bruce H. Pomeranz, MD, PhD; Paul N. Corey, PhD JAMA. 1998;279:1200-1205. Objective.- To estimate the incidence of serious and fatal adverse drug reactions (ADR) in hospital patients. Data Sources.- Four electronic databases were searched from 1966 to 1996. Study Selection.- Of 153, we selected 39 prospective studies from US hospitals. Data Extraction.- Data extracted independently by 2 investigators were analyzed by a random-effects model. To obtain the overall incidence of ADRs in hospitalized patients, we combined the incidence of ADRs occurring while in the hospital plus the incidence of ADRs causing admission to hospital. We excluded errors in drug administration, noncompliance, overdose, drug abuse, therapeutic failures, and possible ADRs. Serious ADRs were defined as those that required hospitalization, were permanently disabling, or resulted in death. Data Synthesis.- The overall incidence of serious ADRs was 6.7% (95% confidence interval [CI], 5.2%-8.2%) and of fatal ADRs was 0.32% (95% CI, 0.23%-0.41%) of hospitalized patients. We estimated that in 1994 overall 2216000 (1721000-2711000) hospitalized patients had serious ADRs and 106000 (76000-137000) had fatal ADRs, making these reactions between the fourth and sixth leading cause of death. Conclusions.- The incidence of serious and fatal ADRs in US hospitals was found to be extremely high. While our results must be viewed with circumspection because of heterogeneity among studies and small biases in the samples, these data nevertheless suggest that ADRs represent an important clinical issue. http://jama.ama-assn.org/cgi/content/abstract/279/15/1200 > Objective.- To estimate the incidence of serious and fatal adverse > drug reactions (ADR) in hospital patients. > > Data Sources.- Four electronic databases were searched from 1966 to > 1996. Ok. What vitamins do you suggest instead? What do you mean by "What vitamins do you suggest instead". Vitamins are essential for life. You can go to my blog and search for whatever modality you want. I just started the blog 6 months ago so I only have 570 pages to choose from but I hope you can find some information that would be of use to you. For instance I have an article called "L-Carnitine prevents Hypoglycemia-induced Neuronal Damage" in my diabetes folder. http://debunkbigpharma.blognation.us/blog > What do you mean by "What vitamins do you suggest instead". Vitamins > are essential for life. You can go to my blog and search for whatever [quoted text clipped - 6 lines] > > http://debunkbigpharma.blognation.us/blog I would love to see you treating patients in the intensive care unit or hospital in general. I mean which vitamins do you suggest they be used in pulmonary embolism in avoiding heparin which may cause intracerebral hemorrhage? Which vitamin do you suggest for bacterial endocarditis in avoiding antibiotics that can kill people with renal, liver, ear damage? I would have said acupuncture until I saw "Patient reports of adverse events associated with acupuncture treatment: a prospective national survey" Results: 9408 patients gave baseline information and consent and 6348 (67%) completed 3 month questionnaires. Responders were not dissimilar to non-responders for all known characteristics. 682 patients reported at least one adverse event over 3 months, a rate of 107 per 1000 patients (95% CI 100 to 115). Three patients reported a serious adverse event. The most common events reported were severe tiredness and exhaustion, pain at the site of needling, and headache. Patients receiving acupuncture treatment that was not funded by the NHS and patients not in contact with a GP or hospital specialist were less likely to report adverse events (odds ratios 0.59 and 0.66, respectively). 199 (3%) of responding patients reported receiving advice about conventional/prescribed medication, six of whom reported adverse consequences after taking the advice. Two patients reported delayed conventional treatment. Hey Robert are you so stupid that you think supplements are as strong as drugs and can be use for life saving measures? I don't think supplements are as strong as drugs. What is your point? You make no sence. Where in any statement have I EVER made did I write that supplements should be used in place of drugs in a life or death situation? Where do you work? I want to make sure I never get any advice on healing from you or anyone influenced by you. I think from your negitive attitude that you are suffering from very aggressive behavior and are a very frustrated person. Did someone cut you off from your prescription drug stash this week? What does acupuncture have to do with vitamins or nutritional supplements anyway? Explain yourself please, you are not making logical arguments. > Hey Robert are you so stupid that you think supplements are as strong > as drugs and can be use for life saving measures? Don't know you Dan, just asking. I don't think > supplements are as strong as drugs. What is your point? You make no > sence. Where in any statement have I EVER made did I write that [quoted text clipped - 3 lines] > Where do you work? I want to make sure I never get any advice on > healing from you or anyone influenced by you. That's a secret until you tell me where you work. That's fair. I think from your > negitive attitude that you are suffering from very aggressive behavior > and are a very frustrated person. Did someone cut you off from your > prescription drug stash this week? Dan, I am responding to your negative posts. Next time I will just leave it at that. You aren't getting any takers and there is no real application for people here to learn from. > What does acupuncture have to do with vitamins or nutritional > supplements anyway? Explain yourself please, you are not making > logical arguments. Dan, from your original post here concerning adverse drug reaction which mentioned acupuncture in that link you provided. Evidently you picked the header when it should have been medical remedies and not just drugs as they mentioned acupuncture. They also mentioned herbal remedies and complications with anti-cancer drugs making them drug interactions with supplements that they never mentioned to their doctor about. When they get an AE is it blamed on the drug or the supplement? I would suggest you read the links you post before you spin the information. Supplements of omega-3 fatty acids may mitigate aggressive behavior in substance abusers, suggest researchers. http://debunkbigpharma.blognation.us/blog/_archives/2006/1/23/1719830.html >A Meta-analysis of Prospective Studies > [quoted text clipped - 4 lines] >Objective.- To estimate the incidence of serious and fatal adverse >drug reactions (ADR) in hospital patients. I'm aware of this study; I've already commented on it. It's a pity you don't know more. My comments were in m.h.a, so maybe you missed them, you poor sod. Let me fill you in a little. This is from a GAO report in 2000: http:www.gao.gov/new.items/he00053t.pdf Recently, Lazarou, Pomeranz, and Corey attempted to synthesize available data on fatalities from adverse drug events (excluding cases of medication error). To derive their estimate of 106,000 fatal adverse drug reactions in the United States in 1994, they drew on data from 16 studies of adverse drug reactions published between 1964 and 1995. The studies cumulatively looked at 78 deaths, but only two of the studies had more than 10 deaths. Moreover, the 4 studies published after 1976 included a total of 5 deaths, compared with 73 in the 12 earlier studies. Consequently, the projection of fatal adverse drug reactions in 1994 is based predominately on data from 20 years earlier, when the use of pharmaceuticals was quite different. In addition, deaths were too few to arrive at a stable mortality estimate -- as even a small change in the number of deaths reported in the studies would lead to substantial changes in the number of deaths extrapolated to the national population. They're being politer than I would be, but in summary, Lazarou's figures are bullshit, the sample sizes are too small to allow you to draw any conclusions, and the referees for JAMA should be flogged. -- David Wright :: alphabeta at prodigy.net These are my opinions only, but they're almost always correct. "If you can't say something nice, then sit next to me." -- Alice Roosevelt Longworth I would not agree that the figures are bulls..t but I would say that all Meta-studies are sketchy. Many times the authors can pick & choose the studies studied to come up with a predetermined outcome. No one can deny dangerous drugs are being handed out like candy to keep the masses happy. People are getting fatter and are not anymore happier or healthier. American style medicine looks towards extending life but doesn't care about improving the quality of life. Just like in Rome my friend, Bread & Circus while the country implodes. >I would not agree that the figures are bulls..t but I would say that >all Meta-studies are sketchy. Do you suppose you could get yourself a real newsreader, one that allows you to include text from the posting to which you are responding? That way, readers might have a fighting chance to know what the hell you're writing about. The figures in Lazarou et al are bullshit. They're useless. They're the same as saying that by studying the two fatal car crashes in some tiny town over a ten-year period, I can tell you how many there were nationally. >No one can deny dangerous drugs are being handed out like candy to >keep the masses happy. There's an element of truth to that, but I can deny that it's really accurate. >People are getting fatter and are not anymore happier or healthier. >American style medicine looks towards extending life but doesn't care >about improving the quality of life. Strongly disagree. >Just like in Rome my >friend, Bread & Circus while the country implodes. More like explodes, if you're going to mention obesity. -- David Wright :: alphabeta at prodigy.net These are my opinions only, but they're almost always correct. "If you can't say something nice, then sit next to me." -- Alice Roosevelt Longworth >People are getting fatter and are not anymore happier or healthier. >American style medicine looks towards extending life but doesn't care >about improving the quality of life. Strongly disagree. How do you strongly disagree? Have you seen the movie "Super Size Me"? Go to any Wal-Mart & you will see so many fat people you'll have to peek into their shopping carts just to see what NOT to buy. You think people are happier than they were 10 years ago? Now anyone who disagrees with King George is being called a terriorist. You think that people are more secure or less terrorified than 10 years ago? You think people are healthier than 10 years ago. So why is the American Health Care system crumbling? Why are more people on more prescription drugs than ever before? If American was filled with slim people Wal-Mart wouldn't need to increase the physical size of the M, L, XXL size clothes & wouldn't even carry XXXL. If people were happier and more secure they wouldn't be giving away the Constitution in order for King George to keep us more secure. If people were healthier the country wouldn't be 70% overweight & 50% obese like it is. People may live longer but they get that way by being stuck in a bed, hooked to a machine & having tubes sticking out of them. Dan: Here is how you quote in googlegroups. Hit "show options" intead of "Reply". Then hit the new "Reply" in the expanded box (of now "shown" options). P.S. Coconut warrior, you too. >>>People are getting fatter and are not anymore happier or healthier. >>>American style medicine looks towards extending life but doesn't care [quoted text clipped - 5 lines] >Me"? Go to any Wal-Mart & you will see so many fat people you'll have >to peek into their shopping carts just to see what NOT to buy. I didn't disagree that people are getting fatter. Obviously, they are. I disagree that American medicine doesn't care about quality of life. >If people were happier and >more secure they wouldn't be giving away the Constitution in order for >King George to keep us more secure. That's an entirely separate issue. They'd also need to be smarter. -- David Wright :: alphabeta at prodigy.net These are my opinions only, but they're almost always correct. "If you can't say something nice, then sit next to me." -- Alice Roosevelt Longworth |
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