Sex differences associated with adverse drug reactions resulting in hospital admissions

• Published in: Biology of sex differences Vol. 12; no. 1; p. 34
• Main Authors: Hendriksen, L C, van der Linden, P D, Lagro-Janssen, A L M, van den Bemt, P M L A, Siiskonen, S J, Teichert, M, Kuiper, J G, Herings, R M C, Stricker, B H, Visser, L E
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 03.05.2021; BioMed Central; BMC
• Subjects: Admission and discharge; Adverse drug reactions; Age; Anticoagulants; Anticoagulants (Medicine); Complications and side effects; Disease susceptibility; Diuretics; Drug stores; Drug use; Gender differences; Hematuria; Hemorrhage; Hospital admissions; Hospitalization; Hospitals; Patient admissions; Pharmacoepidemiology; Pharmacy; Population; Rectum; Sex differences; Women; Netherlands; Pharmacoepidemiology; Hospital admissions; Sex differences; Adverse drug reactions
• ISSN: 2042-6410; 2042-6410
• DOI: 10.1186/s13293-021-00377-0

Adverse 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. ADR-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. A 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. There 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.