Sex differences associated with adverse drug reactions resulting in hospital admissions

Biology of Sex Differences

M. Teichert¹  P. M. L. A. van den Bemt²  P. D. van der Linden³  B. H. Stricker⁴  L. E. Visser⁵  L. C. Hendriksen⁶  A. L. M. Lagro-Janssen⁷  S. J. Siiskonen⁸  J. G. Kuiper⁹  R. M. C. Herings^1,10 

[1]Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, Leiden, The Netherlands

[2]Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, Groningen, The Netherlands

[3]Department of Clinical Pharmacy, Tergooi Hospital, Hilversum, The Netherlands

[4]Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands

[5]Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands

[6]Department of Clinical Pharmacy, Haga Teaching Hospital, The Hague, The Netherlands

[7]Department of Hospital Pharmacy, Erasmus Medical Center, Rotterdam, The Netherlands

[8]Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands

[9]Department of Clinical Pharmacy, Tergooi Hospital, Hilversum, The Netherlands

[10]Department of Primary and Community Care, Gender and Women’s Health, Radboud University Medical Centre, Nijmegen, The Netherlands

[11]Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands

[12]Doctoral Programme in Population Health, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland

[13]PHARMO Institute for Drug Outcomes Research, Utrecht, The Netherlands

[14]PHARMO Institute for Drug Outcomes Research, Utrecht, The Netherlands

[15]Department of Epidemiology and Data Science, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands

关键词: Sex differences;    Adverse drug reactions;    Hospital admissions;    Pharmacoepidemiology;   

DOI  :  10.1186/s13293-021-00377-0

来源: Springer

【 摘 要 】

BackgroundAdverse drug events, including adverse drug reactions (ADRs), are responsible for approximately 5% of unplanned hospital admissions: a major health concern. Women are 1.5–1.7 times more likely to develop ADRs. The main objective was to identify sex differences in the types and number of ADRs leading to hospital admission.MethodsADR-related hospital admissions between 2005 and 2017 were identified from the PHARMO Database Network using hospital discharge diagnoses. Patients aged ≥ 16 years with a drug possibly responsible for the ADR and dispensed within 3 months before admission were included. Age-adjusted odds ratios (OR) with 95% CIs for drug-ADR combinations for women versus men were calculated.ResultsA total of 18,469 ADR-related hospital admissions involving women (0.35% of all women admitted) and 14,678 admissions involving men (0.35% of all men admitted) were included. Most substantial differences were seen in ADRs due to anticoagulants and diuretics. Anticoagulants showed a lower risk of admission with persistent haematuria (ORadj 0.31; 95%CI 0.21, 0.45) haemoptysis (ORadj 0.47, 95%CI 0.30,0.74) and subdural haemorrhage (ORadj 0.61; 95%CI 0.42,0.88) in women than in men and a higher risk of rectal bleeding in women (ORadj 1.48; 95%CI 1.04,2.11). Also, there was a higher risk of admission in women using thiazide diuretics causing hypokalaemia (ORadj 3.03; 95%CI 1.58, 5.79) and hyponatraemia (ORadj 3.33, 95%CI 2.31, 4.81) than in men.ConclusionsThere are sex-related differences in the risk of hospital admission in specific drug-ADR combinations. The most substantial differences were due to anticoagulants and diuretics.

【 授权许可】

CC BY