Evidence map›Paper›PMID 15231615›Full record

ArticleBMJ (Clinical research ed.)2004

Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 820 patients.

Munir Pirmohamed, Sally James, Shaun Meakin, Chris Green, Andrew K Scott, Thomas J Walley, Keith Farrar, B Kevin Park, Alasdair M Breckenridge

3 registry-linked trialsAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ (Clinical research ed.), 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 1,148 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1,148citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00990158 phase3completednot on this mapstarted 2010, after this paper: background citation

A Multicentre Study of Low Dose Oral Vitamin K for INR Control in Patients Receiving Warfarin

TypeinterventionalSponsorSt. Joseph's Healthcare HamiltonRan2010 to 2014Enrolled235ConditionsCoagulation, Bleeding, ThrombosisArmsPhytonadione (Vitamin K1), Placebo
NCT03512080 completednot on this mapstarted 2018, after this paper: background citation

National Institute of Health Research (NIHR) Global Health Research Group on Warfarin Anticoagulation in Patients with Cardiovascular Disease in Sub-Saharan Africa

Typeobservational_patient_registrySponsorUniversity of LiverpoolRan2018 to 2024Enrolled681ConditionsCardiovascular Diseases
NCT05971407 nacompletednot on this mapstarted 2022, after this paper: background citation

The Effect of Chronic Remote Ischaemic Preconditioning on Blood Pressure in Older Adults

TypeinterventionalSponsorUniversity of NottinghamRan2022 to 2024Enrolled60ConditionsHypertension, Vascular DiseasesArmsRemote Ischaemic Preconditioning, Sham Remote Ischaemic Preconditioning
3 · Its place in the literature

Who cites it

1,148 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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  3. Improving adverse drug event reporting by healthcare professionals.The Cochrane database of systematic reviews · 2024
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1,088 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Munir PirmohamedDepartment of Pharmacology and Therapeutics, University of Liverpool, Liverpool L69 3GE. munirp@liv.ac.uk
Sally James
Shaun Meakin
Chris Green
Andrew K Scott
Thomas J Walley
Keith Farrar
B Kevin Park
Alasdair M Breckenridge

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo ascertain the current burden of adverse drug reactions (ADRs) through a prospective analysis of all admissions to hospital.

designProspective observational study.

settingTwo large general hospitals in Merseyside, England.

participants18 820 patients aged > 16 years admitted over six months and assessed for cause of admission.

main outcome measuresPrevalence of admissions due to an ADR, length of stay, avoidability, and outcome.

resultsThere were 1225 admissions related to an ADR, giving a prevalence of 6.5%, with the ADR directly leading to the admission in 80% of cases. The median bed stay was eight days, accounting for 4% of the hospital bed capacity. The projected annual cost of such admissions to the NHS is 466m pounds sterling (706m Euros, 847m dollars). The overall fatality was 0.15%. Most reactions were either definitely or possibly avoidable. Drugs most commonly implicated in causing these admissions included low dose aspirin, diuretics, warfarin, and non-steroidal anti-inflammatory drugs other than aspirin, the most common reaction being gastrointestinal bleeding.

conclusionThe burden of ADRs on the NHS is high, accounting for considerable morbidity, mortality, and extra costs. Although many of the implicated drugs have proved benefit, measures need to be put into place to reduce the burden of ADRs and thereby further improve the benefit:harm ratio of the drugs.

Indexed as

AdolescentAdultAgedBed OccupancyDrug-Related Side Effects and Adverse ReactionsEnglandFemaleHospital CostsHospitalizationHospitals, GeneralHumansMaleMiddle AgedPrevalencePrognosisProspective Studies

Identifiers

PMID15231615
PMCPMC443443

What OpenQuestion holds

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Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.