Roblot P, de Bayser L, Barrier J, Maréchaud R, Becq-Giraudon B
Service de médecine interne et maladies infectieuses, CHU La Milétrie, Poitiers, France.
Rev Med Interne. 1994;15(11):720-6. doi: 10.1016/s0248-8663(05)81397-9.
One hundred and fifteen cases of iatrogenic disorders were observed in 106 patients during a one-year prospective study. Each case was included after informed agreement of two investigators. Each case was classified into 4 groups, according to duration time between iatrogenic disorder and hospitalization, and into 3 sections according to responsibility of causative agent. A control group of 200 patients matched for age and sex was studied. Patients represented 8% of the hospitalisations. Mean age (69.2 years) was higher than other patients hospitalized during the same period (61.6 years). Principal causative agents were diuretics (30), physchotrops (13) and technic examinations (12). Main pathologies were electrolytes disorders (28), orthostatic hypotension (19), confusion and/or alteration of mental functions (13), and cutaneous or allergic disorders (12). Mean induced hospitalization duration time was of 8 days. Mean estimate cost was 18,808 francs per patient. Associated factors were elderly, and an elevated number of drugs. A negligency could participate to iatrogenic disorders in 50% of cases. Half part of iatrogenic disorders could be avoided by using simple precautions: respect of contra-indications, restriction on self-therapy and of number of associated drugs.
在一项为期一年的前瞻性研究中，对106例患者观察到115例医源性疾病。每例均在两名研究者知情同意后纳入研究。根据医源性疾病与住院之间的持续时间，将每例分为4组；根据致病因素的责任，分为3个部分。研究了一个由200名年龄和性别匹配的患者组成的对照组。患者占住院患者的8%。平均年龄（69.2岁）高于同期住院的其他患者（61.6岁）。主要致病因素为利尿剂（30例）、精神药物（13例）和技术检查（12例）。主要病理情况为电解质紊乱（28例）、体位性低血压（19例）、意识模糊和/或精神功能改变（13例）以及皮肤或过敏性疾病（12例）。平均诱发住院持续时间为8天。平均估计费用为每位患者18,808法郎。相关因素为老年和药物数量增加。在50%的病例中，疏忽可能导致医源性疾病。通过采取简单的预防措施，如遵守禁忌证、限制自我治疗和联合用药数量，一半的医源性疾病是可以避免的。
