Table 2.
Frequency of triggers identified, of adverse drug events identified and Positive Predictive Value in a federal hospital. Rio de Janeiro, RJ, Southeastern Brazil, 2007.
| List of triggers | Trigger per 100 medical records | Adverse drug events per 100 medical records | Positive Predictive Valuea |
|---|---|---|---|
| Antihistamines (dexchlorpheniramine, loratadine, promethazine and epinephrine) | 7.0 | 0.0 | 0.0 |
| Coagulants (vitamin K1 and protamine) | 4.7 | 0.8 | 16.7 |
| Benzodiazepine antagonist (flumazenil) | 0.0 | 0.0 | – |
| Anti-emetic (bromopride, metoclopramide and ondansetron) | 58.6 | 7.0 | 12.0 |
| Opioid antagonist (naloxone) | 0.0 | 0.0 | – |
| Anti-diarrhea (loperamide) | 1.6 | 0.0 | 0.0 |
| Ion-exchange resin (calcium polystyrene sulfonate) | 0.8 | 0.0 | 0.0 |
| Blood sugar < 50 mg/dL | 2.3 | 0.8 | 33.3 |
| PTT > 100 seconds | 0.0 | 0.0 | – |
| INR > 6 | 0.0 | 0.0 | – |
| Leucocytes < 3.000 | 1.6 | 0.0 | 0.0 |
| Platelets < 50.000 | 0.8 | 0.0 | 0.0 |
| Use of digoxin and arrhythmia, bradycardia, nausea, vomiting, anorexia, or visual changes | 2.3 | 0.8 | 33.3 |
| Elevated serum creatinine | 8.6 | 1.6 | 18.2 |
| Excessive drowsiness, lethargy, fall, hypotension | 27.3 | 7.0 | 25.7 |
| Rash | 0.8 | 0.8 | 100.0 |
| Sudden interruption of medication | 63.3 | 7.8 | 12.4 |
| Transfer to a higher level of care | 5.5 | 0.0 | 0.0 |
| Total | 185.2 | 26.6 | 14.4 |
a
PPV = nº of medical records in which the trigger indicated ADE x 100/nº of medical records in which the trigger indicated ADE + nº of medical records in which the trigger did not indicate ADE. The denominator is the number of times the trigger occurred, indicating, or not, ADE. Example: anti-emetic: 7.0 x 100/58.6 = 12.0.