Adverse drug events in Chinese pediatric inpatients and associated risk factors: a retrospective review using the Global Trigger Tool

Huan-Huan Ji,Ting-Ting Tang,Lin Song,Jian-Wen Xiao,Xue-Wen Tang,Yu-Xia Guo,Xiao-Jiang Tian,Yun-Tao Jia,Ping Wei

doi:10.1038/s41598-018-20868-2

Abstract

Understanding the epidemiology and risk factors of adverse drug events (ADEs) in pediatric inpatient is essential if we are to prevent, reduce or ameliorate the harm experienced. The Global Trigger Tool (GTT) is a method of retrospective medical record review that measures harm in hospitalized children. We employed a three-stage retrospective chart review of random samples of 1800 pediatric inpatients discharged from January 2013 to December 2015. 31 kinds of pediatric-specific triggers were made based on the previous trigger tool studies developed for use in adult or pediatric. Positive predictive value (PPV) of individual triggers, as well as ADEs detection rates were calculated. Stepwise logistic regression was performed to investigate risk factors associated with ADEs. Of 1746 patients, detected in 221 patients (12.7%) with 247 ADEs. The PPV of the trigger tool was 13.3%. Of the 247 ADEs, 82.6% were identified as category E, 11.7% category F and 5.7% category H. The pediatric-focused trigger tool is a feasible and useful tool for detecting pediatric ADEs. Especially for patients who have had more drugs, more doses or more admissions which needs to be closely monitored as triggers to improve the safety.

Highlights

Adverse drug events (ADEs) are defined by the Institute of Medicine (IOM) as injuries resulting from a medical intervention related to a drug and can manifest as signs, symptoms or laboratory abnormalities[1]
With regard to risk factors associated with adverse drug events (ADEs) in pediatric patients, significant differences have been found in terms of the number of drugs[14], length of hospital stay[15], use of antibacterial[15] and general anesthesia[16]
Little is known about the performance of the Global Trigger Tool (GTT) and risk factors associated with the occurrence of ADEs in Chinese pediatric inpatients

Summary

Introduction

Adverse drug events (ADEs) are defined by the Institute of Medicine (IOM) as injuries resulting from a medical intervention related to a drug and can manifest as signs, symptoms or laboratory abnormalities[1] This is more general definition than that provided by the World Health Organization, which defined an adverse drug reaction (ADR) as a response to a drug, which is noxious and unintended, and occurs at doses normally used in man for prophylaxis, diagnosis or therapy of disease, or for the modification of physiologic function[2]. With regard to risk factors associated with ADEs in pediatric patients, significant differences have been found in terms of the number of drugs[14], length of hospital stay[15], use of antibacterial[15] and general anesthesia[16].

Objectives

Results

Conclusion