Risk assessment for cardiovascular adverse drug events in the ICU: Case study on COVID-19 patients.

The vast majority of COVID-19 ICU patients were classified as high cardiovascular risk at baseline using the Tisdale score.

• 96.0% of patients were classified as high-risk prior to any intervention
• Analysis was based on 141 medical records of COVID-19 patients admitted to an ICU reference hospital in Brasília, Brazil in 2020
• The Tisdale score was used as the risk assessment tool
• Brazil recorded more than seven million COVID-19 cases in 2020

Simulated hypothetical drug substitutions reduced the proportion of high-risk patients by 53%.

• High-risk patients decreased from 96.0% to 43.0% after simulated prescription intervention
• 56% of patients began to show a Tisdale score of medium or low risk in the optimized prescription condition
• Simulations were performed using MedUTI software
• The intervention involved hypothetical drug substitutions rather than actual clinical changes

The total number of medications with serious cardiovascular adverse drug events decreased following simulated prescription optimization.

• Medications with serious cardiovascular ADEs decreased from 67 to 51
• QT interval prolongation-associated medications decreased from 37 to 30
• Torsades de Pointes-associated medications decreased from 21 to 15
• Serotonin syndrome (SS)-associated medications decreased from 9 to 6

COVID-19 ICU patients were subject to qualitative polypharmacy, increasing their risk of serious cardiovascular adverse drug reactions.

• Most patients affected by COVID-19 were admitted to intensive care units requiring qualitative polypharmacy
• Polypharmacy in the ICU setting was identified as a key driver of increased cardiovascular ADE risk
• Cardiovascular ADEs assessed included QT interval prolongation, Torsades de Pointes, and serotonin syndrome
• The study was conducted at a reference hospital for COVID-19 treatment in Brasília, Brazil

Technology-assisted medication management using decision-support software was identified as a tool capable of substantially reducing cardiovascular risk in ICU settings.

• MedUTI software was used to simulate hypothetical drug substitutions
• The software-assisted approach demonstrated a 53% reduction in high-risk classifications
• Authors concluded that 'the use of technologies to support healthcare professionals' work can be decisive for patient survival, especially in ICU overcrowding scenarios'
• The COVID-19 medical emergency highlighted the need for rapid medication management in ICU patients