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Abstract

Introduction: The impact of drug-related events on patient outcomes and healthcare resource utilization is highly impactful. The extent that patients with drug-related problems can result in ICU admissions and the related outcomes have not been fully elucidated from a multi-institutional perspective. The purpose of this study was to examine drug related admissions to the ICU in multiple centers within North America. Methods: A retrospective data collection of adult patients admitted to medical ICUs at three institutions was completed to assess all drug-related admissions. Study centers were randomly assigned a month period from the year 2012 for data collection. Drug-related admissions were examined in detail including an evaluation of severity using the National Cancer Institute Common Terminology Criteria for Adverse Events, resources used, and patient outcomes. Descriptive statistics were used to describe the types of drug related ICU admissions, as well as patient demographics. Results: Within 3 different ICUs, 38 out of 463 patients were admitted for a drug related cause (7.6%). The average age and APACHE II score of included patients was 47.1 ± 20.6 years and 9.9 ± 6.0, respectively. The most common etiology of admission included adverse drug reactions (n=17) and intentional overdose (n=9). Most common medications involved in these included anticoagulants, benzodiazepines, and alcohol. Severity of drug-related ICU admissions was graded as life threatening in 48.6% (n=17) and fatal in 8.6% (n=3) of patients. Mechanical ventilation was required in 63.2% (n=24) of patients, while vasopressors were required in 31.6% (n=12). Average length of stay in ICU was 4.9 ± 16.8 days, with 86.8% of patients surviving their ICU stay. Conclusions: Adverse drug reactions comprised almost half of the drug-related ICU admissions. Drug related admissions to the ICU utilized many resources.