Adverse drug reactions appear to be a major cause of death among hospital patients in the United States, a new study reported on Tuesday.
Researchers at the University of Toronto, who examined 39 studies, estimated that an average of 106,000 deaths at U.S. hospitals in 1994 were due to bad reactions to drugs. "Serious adverse drug reactions are frequent ... more so than generally recognized," the researchers said. "Fatal adverse drug reactions appear to be between the fourth and sixth leading cause of death." Heart disease is the leading cause of death in America, followed by cancer and stroke. Other major causes are accidents, pulmonary disease.
The report estimated the number of deaths in 1994 from adverse reactions at between 137,000 and 76,000 with 106,000 the mean. If the higher end is correct, drug reactions would be the fourth leading cause of death behind heart disease (743,460), cancer (529,904) and stroke (150,108), the study said. If the low end is accurate drug reactions would be the sixth leading cause of death, behind the top three plus pulmonary disease (101,077) and accidents (90,523).
The report, published in this week's Journal of the American Medical Association, included patients admitted to hospitals with adverse drug reactions and those whose reactions occurred after they were admitted. The study excluded errors in administration, noncompliance with instructions and drug abuse. The researchers said their results suggest an "important clinical issue," but they recommended cautious interpretation. An accompanying editorial by David Bates of Boston's Brigham and Women's Hospital also urged careful analysis. Bates said "combining the results of small, heterogeneous studies does not necessarily bring one closer to truth."
Nevertheless, he added, "these data are important, and even if the true incidence of adverse drug reactions is somewhat lower than that reported ... it is still high, and much higher than generally recognized."
Jeff Stier, associate director of the New York-based American Council on Science and Health, said in an interview that drugs also save countless lives, a fact that may be obscured when analyzing adverse reactions.
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