Table 1.
Adverse Events from 2005–2006 to 2010–2011.*
| Event | Acute Myocardial Infarction | Congestive Heart Failure |
Pneumonia | Conditions Requiring Surgery | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2005–2006 | 2007 and 2009† | 2010–2011 | 2005–2006 | 2007 and 2009† | 2010–2011 | 2005–2006 | 2007 and 2009† | 2010–2011 | 2005–2006 | 2007 and 2009† | 2010–2011 | |
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| number of events/total number (percent) | ||||||||||||
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| Adverse drug events | ||||||||||||
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| Events associated with digoxin | 0/85 | 2/124 (1.6) | 7/398 (1.8) | 1/514 (0.2) | 1/393 (0.3) | 5/963 (0.5) | 0/310 | 3/370 (0.8) | 5/628 (0.8) | 1/187 (0.5) | 3/126 (2.4) | 1/215 (0.5) |
|
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| Events associated with hypoglycemic agents | 72/550 (13.1) | 100/866 (11.5) | 325/3033 (10.7) | 162/1062 (15.3) | 152/1288 (11.8) | 497/3946 (12.6) | 121/1012 (12.0) | 224/1685 (13.3) | 460/3921 (11.7) | 181/1613 (11.2) | 152/1650 (9.2) | 270/2710 (10.0) |
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| Events associated with IV heparin | 96/540 (17.8) | 78/625 (12.5) | 216/2123 (10.2)‡ | 24/189 (12.7) | 15/132 (11.4) | 40/301 (13.3) | 17/99 (17.2) | 10/95 (10.5) | 63/284 (22.2) | 146/567 (25.7) | 66/258 (25.6) | 140/437 (32.0)§ |
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| Events associated with LMW heparin and factor Xa inhibitor | 47/566 (8.3) | 54/962 (5.6) | 158/3658 (4.3)‡ | 32/731 (4.4) | 27/973 (2.8) | 95/3317 (2.9) | 40/750 (5.3) | 50/1571 (3.2) | 192/4081 (4.7) | 195/1605 (12.1) | 181/2055 (8.8) | 414/3748 (11.0) |
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| Events associated with warfarin | 12/150 (8.0) | 16/231 (6.9) | 40/693 (5.8) | 29/727 (4.0) | 24/798 (3.0) | 85/2335 (3.6) | 38/426 (8.9) | 35/683 (5.1) | 130/1441 (9.0) | 130/1555 (8.4) | 72/1420 (5.1) | 154/2056 (7.5) |
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| General events | ||||||||||||
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| Hospital-acquired pressure ulcers | 69/1360 (5.1) | 114/2223 (5.1) | 409/7816 (5.2) | 154/2689 (5.7) | 162/3268 (5.0) | 511/9417 (5.4) | 262/2889 (9.1) | 404/4900 (8.2) | 987/10,480 (9.4) | 256/4814 (5.3) | 243/4855 (5.0) | 485/7594 (6.4)¶ |
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| Inpatient falls | 17/1360 (1.3) | 34/2223 (1.5) | 62/7816 (0.8)¶ | 36/2689 (1.3) | 46/3268 (1.4) | 111/9417 (1.2) | 40/2889 (1.4) | 81/4900 (1.7) | 134/10,480 (1.3) | 79/4814 (1.6) | 75/4855 (1.5) | 90/7594 (1.2)§ |
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| Hospital-acquired infections | ||||||||||||
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| Antibiotic-associated Clostridium difficile infection | 4/587 (0.7) | 5/955 (0.5) | 15/3484 (0.4) | 8/1283 (0.6) | 4/1642 (0.2) | 21/4878 (0.4) | 28/2850 (1.0) | 33/4841 (0.7) | 83/10,361 (0.8) | 22/4703 (0.5) | 17/4781 (0.4) | 33/7558 (0.4) |
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| Central catheter–associated bloodstream infections | 4/205 (2.0) | 3/273 (1.1) | 8/743 (1.1) | 3/124 (2.4) | 0/101 | 2/338 (0.6) | 0/40 | 1/38 (2.6) | 2/109 (1.8) | 21/1175 (1.8) | 14/1039 (1.3) | 22/1489 (1.5) |
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| Catheter-associated UTIs | 50/586 (8.5) | 40/780 (5.1) | 167/2673 (6.2) | 87/1147 (7.6) | 67/1284 (5.2) | 192/3459 (5.6)§ | 40/952 (4.2) | 57/1416 (4.0) | 138/3171 (4.4) | 131/3959 (3.3) | 146/3905 (3.7) | 238/6357 (3.7) |
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| MRSA infections | 0/1348 | 1/2179 (<0.1) | 5/7629 (0.1) | 4/2653 (0.2) | 0/3190 | 4/9179 (<0.1) | 3/2728 (0.1) | 4/4612 (0.1) | 8/9808 (0.1) | 13/4776 (0.3) | 1/4793 (<0.1) | 9/7507 (0.1) |
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| Vancomycin-resistant enterococcus | 0/1359 | 0/2219 | 0/7794 | 1/2678 (<0.1) | 0/3253 | 3/9383 (<0.1) | 0/2855 | 2/4861 (<0.1) | 10/10,384 (0.1) | 5/4802 (0.1) | 3/4834 (0.1) | 5/7574 (0.1) |
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| Postoperative pneumonia | 4/151 (2.6) | 8/156 (5.1) | 28/334 (8.4)§ | 3/54 (5.6) | 3/27 (11.1) | 0/26 | 3/6 (50.0) | 1/10 (10.0) | 10/30 (33.3) | 107/4559 (2.3) | 99/4652 (2.1) | 237/7248 (3.3)‡ |
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| Ventilator-associated pneumonia | 5/57 (8.8) | 7/78 (9.0) | 19/191 (9.9) | 3/21 (14.3) | 0/15 | 1/49 (2.0)§ | 8/50 (16.0) | 5/48 (10.4) | 24/193 (12.4) | 16/167 (9.6) | 11/167 (6.6) | 33/310 (10.6) |
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| Postprocedural events | ||||||||||||
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| Events associated with femoral-artery puncture for catheter-based angiographic procedures | 31/747 (4.1) | 22/967 (2.3) | 56/2586 (2.2)¶ | 2/165 (1.2) | 1/113 (0.9) | 6/359 (1.7) | 0/18 | 0/22 | 0/75 | 14/482 (2.9) | 4/363 (1.1) | 10/566 (1.8) |
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| Events associated with hip replacement | 0/2 | 1/1 (100.0) | 2/3 (66.7) | NA | NA | 0/1 | NA | 0/2 | 0/3 | 43/826 (5.2) | 68/938 (7.2) | 164/1649 (9.9)‡ |
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| Events associated with knee replacement | NA | NA | NA | NA | NA | NA | NA | NA | NA | 42/1254 (3.3) | 44/1336 (3.3) | 115/2158 (5.3)¶ |
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| Contrast-induced nephropathy associated with catheter-based angiography | 75/744 (10.1) | 117/938 (12.5) | 354/2570 (13.8)¶ | 41/184 (22.3) | 16/103 (15.5) | 45/345 (13.0)¶ | 6/60 (10.0) | 3/19 (15.8) | 19/69 (27.5)§ | 116/528 (22.0) | 82/367 (22.3) | 169/577 (29.3)¶ |
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| Mechanical complications associated with central catheters | 9/241 (3.7) | 7/344 (2.0) | 27/965 (2.8) | 3/164 (1.8) | 8/171 (4.7) | 22/560 (3.9) | 15/341 (4.4) | 22/472 (4.7) | 64/1570 (4.1) | 38/1374 (2.8) | 25/1235 (2.0) | 64/1845 (3.5) |
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| Postoperative cardiac events ∥ | 18/169 (10.7) | 4/169 (2.4) | 13/356 (3.7)¶ | 1/69 (1.4) | 0/29 | 1/31 (3.2) | 1/61 (1.6) | 0/37 | 5/74 (6.8) | 90/4712 (1.9) | 46/4764 (1.0) | 100/7460 (1.3)§ |
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| Postoperative venous thromboembolic events | 0/169 | 0/169 | 1/356 (0.3) | 0/69 | 0/29 | 1/31 (3.2) | 1/61 (1.6) | 0/37 | 0/74 | 50/4712 (1.1) | 15/4764 (0.3) | 42/7460 (0.6)¶ |
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| All events | ||||||||||||
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| ||||||||||||
| Overall event rate | 513/10,976 (4.7) | 613/16,482 (3.7) | 1912/55,221 (3.5)‡ | 594/17,212 (3.5) | 526/20,077 (2.6) | 1642/58,335 (2.8)‡ | 623/18,397 (3.4) | 935/30,619 (3.1) | 2334/67,236 (3.5) | 1696/53,184 (3.2) | 1367/53,157 (2.6) | 2795/84,112 (3.3)§ |
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| ≥1 Event per hospitalization | 338/1360 (24.9) | 453/2223 (20.4) | 1420/7816 (18.2)‡ | 463/2689 (17.2) | 456/3268 (14.0) | 1375/9417 (14.6)¶ | 495/2889 (17.1) | 763/4900 (15.6) | 1832/10,480 (17.5) | 1041/4814 (21.6) | 956/4855 (19.7) | 1721/7594 (22.7) |
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| No. of events per 1000 hospitalizations** | 377.2 | 275.8 | 244.6‡ | 220.9 | 161.0 | 174.4‡ | 215.6 | 190.8 | 222.7§ | 352.3 | 281.6 | 368.1‡ |
*
IV denotes intravenous, LMW low-molecular-weight, MRSA methicillin-resistant Staphylococcus aureus, NA not available, and UTI urinary tract infection.
†
Data for 2007 and 2009 do not include data for 2008.
‡
P<0.001 for linear trend from 2005–2006 to 2010–2011.
§
P<0.05 for linear trend from 2005–2006 to 2010–2011.
¶
P<0.01 for linear trend from 2005–2006 to 2010–2011.
∥
Postoperative cardiac events include events after cardiac and noncardiac surgeries.
**
If an adverse event could be counted more than once (e.g., some cases of postoperative pneumonia and ventilator-associated pneumonia), only one was included in the number of adverse events per 1000 hospitalizations.