[A iatrogenic pathology study in an internal medicine service]. 1994

A L Sampéreiz Legarre, and M T Rubio Obanos, and F Escolar Castellón, and J L Alonso Martínez, and A Lanas Arbeloa, and T Ayuso Blanco
Servicio de Medicina Interna, Hospital Reina Sofía de Tudela, Navarra.

BACKGROUND It's obvious that the current medicine practice generates iatrogenesis . However, we are unaware about its magnitude and severity, specially in Spain, where this item has been scarcely studied. METHODS All the patients admitted to the Department of Internal Medicine were prospectively studied during a 13 months period, selecting among the patients those fulfilling criteria for an iatrogenic problem both of pharmacological origin and not pharmacological. The kind of iatrogenesis, its severity, related mortality, gravity of the basic illness, affected organ and avoidability of the iatrogenesis were evaluated. Infusion phlebitis were recorded only during 6 months. RESULTS Iatrogenic pathology was found in 228 cases over 1.549 patients admissions, accounting for 14.7% of incidence. Iatrogenic pathology was the reason for admission in 65 cases. The average stay was significantly increased in patients with iatrogenic pathology (p < 0.01). Adverse reactions to drugs accounted for 62% of the total account with 141 cases. The non-steroids antiinflammatory (NSA) drugs were the most frequently troublesome pharmacological agents. The GI tract was the more affected system (84 cases). Infusion phlebitis are not included in the total account of cases. CONCLUSIONS a) iatrogenic pathology is an illness of very high incidence in our surroundings; b) NSA is a group of drugs generating frequently adverse reactions in off-hospital environment; c) GI hemorrhage is an iatrogenic illness accounting for high percentage of cases; d) many of the iatrogenic events can be catalogued as avoidable and with more accurate attention to some factors the more of them could be prevented.

UI MeSH Term Description Entries
D007049 Iatrogenic Disease Any adverse condition in a patient occurring as the result of treatment by a physician, surgeon, or other health professional, especially infections acquired by a patient during the course of treatment. Hospital-Acquired Condition,Condition, Hospital-Acquired,Conditions, Hospital-Acquired,Disease, Iatrogenic,Diseases, Iatrogenic,Hospital Acquired Condition,Hospital-Acquired Conditions,Iatrogenic Diseases
D007388 Internal Medicine A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. General Internal Medicine,Medicine, Internal,Internal Medicine, General,Medicine, General Internal
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D005260 Female Females
D006748 Hospital Departments Major administrative divisions of the hospital. Departments, Hospital,Department, Hospital,Hospital Department
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000704 Analysis of Variance A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable. ANOVA,Analysis, Variance,Variance Analysis,Analyses, Variance,Variance Analyses

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