Contribution of adverse drug reactions to hospital admission of older patients

Objective: to describe the severity of adverse drug reactions as a factor i n hospital admission of older patients, and to identify risk indicators for severe adverse drug reactions in these patients. Design: observational cross-sectional study. Setting: Five wards in a university hospital in the Netherlands. Subjects: patients aged 70 and over admitted to general medical wards. Methods: use of statistical comparison and Kramer's algorithm. Results: a severe adverse drug reaction was present in 25 (24%) of 106 pati ents, Thirteen patients (12%; 95% confidence interval 6.1-18.6%) were admit ted probably because of an adverse drug reaction, Risk indicators for a sev ere adverse drug reaction were a fall before admission (odds ratio 51.3, P = 0.006), gastrointestinal bleeding or haematuria (odds ratio 19.8, P < 0.0 01) and the use of three or more drugs (odds ratio 9.8, P = 0.04). Conclusion: adverse drug reactions are an important cause of hospital admis sions in older people. A fall before admission may indicate a severe advers e drug reaction.