Adverse Drug Events as a Reason for Adult Hospitalization: A Nationwide Readmission Study

Abstract

Background: Adverse drug events (ADEs) are common; however, there are limited data on the impact of ADEs on post-discharge outcomes. Objectives: To identify ADEs responsible for readmission within 6 months of hospital discharge in the United States. Secondary objectives were to examine whether demographic, clinical, and hospital characteristics were associated with ADE readmission. Methods: We identified all adults hospitalized between January and June using the 2014 Nationwide Readmission Database. Nationally representative estimates of hospitalization outcomes and ADE-related readmissions, excluding ADEs from illicit drug use and intentional overdose, were computed using survey weighting methods. Associations between patient, clinical, and hospital characteristics, and ADE readmission were assessed using unconditional logistic regression. Results: We identified 10 889 282 hospitalizations meeting inclusion criteria. The 6-month readmission rate was 17.8% (n = 1 943 111). A total of 6964 readmissions were attributed to an ADE, most frequently “poisoning by opiates and related narcotics” (18.3%), “poisoning by benzodiazepines” (11.9%), and “dermatitis due to drugs and medicines taken internally” (9.4%). Factors identified as being positively associated with ADE readmission included age <60 years (adjusted odds ratio [AOR] = 1.69; 95% CI = 1.45-1.97), Medicare insurance (AOR = 2.93; 95% CI = 2.55-3.38), and discharge to home health care (AOR = 1.42; 95% CI = 1.28-1.59). Conclusion and Relevance: Readmissions caused by ADEs are frequently attributed to opiate and benzodiazepine poisonings, and factors such as age, insurance status, and discharge disposition were found to be associated with ADE readmission. Future studies are needed to examine whether ADE readmissions are preventable.