[Patients admitted to the intensive care unit for iatrogenic disease. Risk factors and consequences].

PURPOSE

Data pertaining to iatrogenic diseases have been recorded over the last 25 years. Regarding the evolution of medical practice (general ageing, more and more powerful drugs and complex procedures), it is not known whether the incidence and the consequences of iatrogenic diseases have changed since their first evaluation.

METHODS

To determine the admission rate to intensive care units for iatrogenic diseases, with the purpose of analyzing risk factors and consequences, and to compare our results with previous data recorded in 1979 (admission rate: 12.6%, mortality: 20%, preventable events: 47%), a 1-year retrospective study was conducted in an intensive care unit (ICU).

RESULTS

During 1994, 68 (10.9%) out of 623 patients were admitted to the ICU for iatrogenic diseases (drugs: 41, medical acts: 12, surgical acts: 15). They were not different--in terms of severity, mortality, workload and length of stay in the ICU--from the other 555 patients hospitalized for other reasons. They were hospitalized on average for 472 days in the ICU, with a 13% fatality rate and a financial cost of US $688,470. Risk factors for iatrogenic diseases were the age and the number of prescribed drugs. The rate of preventable events was 51%.

CONCLUSIONS

In this study, the occurrence of life-threatening iatrogenic diseases was a persistent and important purpose for admission to the ICU. Risk factors and consequences are still identical to those reported in 1979. Our results emphasize the persistence of the noxious impact of iatrogenic diseases on the quality and cost of medical care.