Abstract
Adverse drug events (ADE) are a primary cause of significant morbidity in older adults and are associated with increased risk of mortality, length of stay, and substantial healthcare costs. This study was conducted to evaluate the clinical (readmission, in-hospital mortality, and length of stay (LOS)) and economic burden of ADE during hospitalization in older adults. Study was conducted in patients 65 years or older using Health Care Cost & Utilization Project’s Nationwide Readmission Database (NRD) 2014 dataset. Patients were selected based on 442 International Classification of Diseases 9th revision Clinical Modification (ICD-9-CM) & external causes of injury codes related to ADEs. Patients were categorized in ADE or non-ADE groups. A logistic regression model was used for multivariable analysis of readmission and in-hospital mortality. Generalized Poisson and inverse Gaussian models were used for LOS and cost multivariable analysis, respectively. 3,832,322 patients were included. Among these patients, 203,432 (5%) patients had at least one ADE during hospitalization. Majority of ADE were related to blood constituents (22%) and adverse effects of biological & medicinal substances in therapeutic use (23%). In adjusted models, older adults with ADE during hospitalization had 25% (p<0.0001) and 9% (p<0.0001) higher odds of readmission and in-hospital mortality, respectively, as compared to those without ADE. A 17% (p<0.0001) increase in LOS was estimated in ADE group and1% point estimate (p>0.05) rise in cost was observed in ADE group when compared with non-ADE group. ADE have substantial burden on in-patient care of older adults both clinically (increased readmission, in-hospital mortality, and LOS) & economically (increased cost). Targeted interventions can help to prevent ADE and, consequently, associated clinical and economic burden.
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