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[住院老年患者的医源性问题]

[Iatrogeny in hospitalized elderly patients].

作者信息

Carvalho-Filho E T, Saporetti L, Souza M A, Arantes A C, Vaz M Y, Hojaiji N H, Alencar Y M, Curiati J E

机构信息

Departamento de Clínica Médica, Faculdade de Medicina, Universidade de São Paulo, SP-Brasil.

出版信息

Rev Saude Publica. 1998 Feb;32(1):36-42. doi: 10.1590/s0034-89101998000100005.

Abstract

PURPOSE

To evaluate the iatrogenic complications in hospitalized elderly patients.

MATERIAL AND METHOD

Review of the medical records of 96 patients, 48 men and 48 women, aged 60 to 93 years (75.7 years on average), hospitalized in a geriatric ward during 1995.

RESULTS

The study of the medical records of the patients showed: 1) forty-two (43.7%) of the elderly had one or more iatrogenic illnesses, with a total of 56 occurrences; 2) complications due to diagnostic tests corresponded to 17.9% of the iatrogenic disorders; 3) complications relating to therapeutic procedures corresponded to 58.9% of the iatrogenic disorders, 32.1% being caused by drugs and 26.8% caused by other therapeutic measures; 4) complications not directly related to diseases, like pressure sores, falls and fractures, corresponded to 23.2% of iatrogenic disorders, 5) iatrogenic illnesses were associated with an extended hospital stay; 6) in five elderly patients the iatrogenic complication was believed to have contributed to the death of the patient.

CONCLUSION

Iatrogenic disorders occur frequently in elderly hospitalized patients and sometimes cause major and even fatal complications. As many of these complications are potentially preventable, we must identify the causes and develop technics to prevent or reduce their effects.

摘要

目的

评估老年住院患者的医源性并发症。

材料与方法

回顾1995年在老年病房住院的96例患者的病历,其中男性48例,女性48例,年龄60至93岁(平均75.7岁)。

结果

对患者病历的研究显示:1)42例(43.7%)老年人患有一种或多种医源性疾病,共发生56次;2)诊断检查引起的并发症占医源性疾病的17.9%;3)治疗操作相关并发症占医源性疾病的58.9%,其中32.1%由药物引起,26.8%由其他治疗措施引起;4)与疾病无直接关联的并发症,如压疮、跌倒和骨折,占医源性疾病的23.2%;5)医源性疾病与住院时间延长有关;6)5例老年患者的医源性并发症被认为导致了患者死亡。

结论

医源性疾病在老年住院患者中频繁发生,有时会引起严重甚至致命的并发症。由于这些并发症中的许多是可以预防的,我们必须找出原因并开发技术来预防或减轻其影响。

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