Hammerman H, Kapeliovich M
Intensive Cardiac Care Unit, Rambam Medical Center, Haifa, Israel.
Isr Med Assoc J. 2000 Aug;2(8):577-9.
Iatrogenic illness, defined as a disease that results from a diagnostic procedure or from any form of therapy, is a well-recognized phenomenon in clinical practice.
To study and evaluate major cardiac iatrogenic disease as the cause of admission to the intensive cardiac care unit in the modern era.
We assessed 64 critically ill patients suffering from major cardiac iatrogenic problems among a total of 2,559 patients admitted to the intensive cardiac care unit during 3 years. Iatrogenic illness was defined as any problem that resulted from therapy. Only cardiac problems were included in the study. Complications of interventional cardiovascular procedures, suicide attempts or accidental intoxications were excluded.
There was evidence of a major cardiac iatrogenic problem as the cause for admission in 64 patients (2.5%): 58 (91%) suffered from arrhythmias (mainly bradyarrhythmias) secondary to beta-blockers, amiodarone, calcium antagonists, electrolyte imbalance or a combination, and 6 (9%) had non-arrhythmic events (hypotension, syncope or acute heart failure). In 41 patients (64%) the iatrogenic event was considered preventable.
Major cardiac iatrogenic complications are an important factor among patients admitted to the intensive cardiac care unit. Most of the events are bradyarrhythmias related to anti-arrhythmic agents. Almost two-thirds of events are preventable.
医源性疾病被定义为由诊断程序或任何形式的治疗导致的疾病，是临床实践中一种广为人知的现象。
研究和评估现代重症心脏监护病房收治患者中主要的心脏医源性疾病。
在3年期间收治入重症心脏监护病房的2559例患者中，我们评估了64例患有主要心脏医源性问题的重症患者。医源性疾病被定义为任何由治疗导致的问题。本研究仅纳入心脏问题。排除介入性心血管手术并发症、自杀未遂或意外中毒。
有证据表明64例患者（2.5%）因主要心脏医源性问题入院：58例（91%）患有继发于β受体阻滞剂、胺碘酮、钙拮抗剂、电解质失衡或多种因素联合作用的心律失常（主要是缓慢性心律失常），6例（9%）发生非心律失常事件（低血压、晕厥或急性心力衰竭）。41例患者（64%）的医源性事件被认为可预防。
主要心脏医源性并发症是重症心脏监护病房收治患者中的一个重要因素。大多数事件是与抗心律失常药物相关的缓慢性心律失常。几乎三分之二的事件是可预防的。
