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1288: PREVALENCE, PREDICTORS, AND OUTCOMES OF ADVERSE DRUG EVENTS IN SURGICAL COHORTS IN THE UNITED STATES

Learning Objectives: Adverse drug events(ADE) in hospitalized patients are associated with significant morbidity and are important quality of care indicators. National estimates of ADEs in hospitalized surgical patients are unknown. We sought to estimate the prevalence and outcomes of occurrence of ADEs in hospitalized surgical cohorts. Further, we identified the predictors of such adverse drug events in this cohort. Methods: We performed a retrospective analysis of the Nationwide Inpatient Sample for year 2014. All hospitalized patients aged ≥18years who had a major surgical procedure(MSP) were selected. Occurrence of an Adverse Event related to Medication use(ADE) was examined. The impact of an ADE on length of stay(LOS) was examined by multivariable linear regression model. Effects of patient and hospital level confounders were adjusted in the model. Patient and hospital level factors associated with occurrence of an ADEs were examined by a multivariable logistic regression model. Results: In the year 2014, a total of 8,704,315 hospitalized adults underwent a MSP. Of these,3.5% experienced an ADE. The overall mean LOS in hospital was 5.2days(10.4d in those that had ADE vs 5d in those who did not experience an ADE). Following adjustment for all confounders, those who had an ADE were associated with significantly longer LOS (Estimate=0.4768;47% higher LOS; p<0.0001) compared to their counterparts. The odds of experiencing an ADE increased with increasing age(OR=1.012;p<0.0001). Females were associated with lower odds of ADE(OR=0.92;95% CI=0.90-0.93;p<0.0001).Whites were associated with higher odds for ADE when compared to Blacks,Hispanics, Asians/Pacific Islanders, and other races(p<0.01).Uninsured were associated with higher odds for ADEs when compared to those covered by Medicare or Medicaid(p<0.01).Odds of an ADE increased with higher household income levels(p<0.0001). Increased co-morbid burden was associated with increased odds for ADEs(OR=1.32;95%CI=1.311.33;p<0.001).Those in the Northeast, Midwest, or Southern regions of the country had lower odds for ADEs compared to those in the Western regions(p<0.0001). Patients in Urban Teaching Hospitals were associated with higher odds for ADEs when compared to their counterparts(OR=1.21;95%CI=1.19-1.24;p<0.01). Conclusions: In this large epidemiological study, nearly 1 in 30 hospitalized surgical patients had an adverse event related to medication use. Those who experienced an ADE had longer length of stay. Predictors of ADEs in surgical cohorts are identified.