Consultations for drug-related bleeding at the Emergency Unit of the Asociación Española Primera de Socorros Mutuos
Abstract
Introduction: during 2007, adverse drug reaction (ADR) determined 4.1% of hospitalizations at Asociación Española Primera de Socorros Mutuos (AEPSM). Gastrointestinal bleeding associated to non-steroidal anticoagulants (NSAID) was a frequent problem.
Objectives:to determine frequency and characteristics of patients who consult for bleeding or alterations in blood crasis associated to drugs, or both, at the Emergency Unit of the AEPSM.
Method: the study analysed all consultations due to bleeding or crasis alterations, or both, at the emergency service between March 24 and April 23, 2008. Those complying with the diagnostic criteria of bleeding or INR alterations were included. The following variables were analysed: age, sex, drugs implied, type of bleeding and severity.
Results: 30 patients (0.45%; IC95% 0.42-0.47) consulted for adverse drug reaction, and 20% of them were hospitalized (1.27%; IC95% 1.30-1.24). ADR were related to anticoagulants (n=19) and non-steroidal anti-inflammatory drugs (n=11). In the ADR due to anticoagulants, average age was 77 and the most frequent drug was warfarina. 15 patients presented five or more concomitant drugs and one patient died. In the ADR group with non-steroidal anti-inflammatory drugs average age was 69, and the most frequent drug was acetylsalicylic acid, eight patients presented polypharmacy and four patients evidenced self-medication.
Conclusions: drug related bleeding constitutes a serious health problem. In most cases it takes place in patients with risk factors for developing a disease resulting from drugs. We need to plan strategies with the purpose of diminishing the impact of this problem.
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