Clinical research studyIatrogenic events resulting in intensive care admission: Frequency, cause, and disclosure to patients and institutions
Section snippets
Background
This study was conducted as part of the project on Care Improvement for the Critically Ill, organized in 1997 by a consortium from the intensive care units at Harvard teaching hospitals in response to emerging controversies in critical care medicine. The complete methods for this project have been published elsewhere.8
Settings
The project on Care Improvement for the Critically Ill was a prospective observational study that examined decision making and satisfaction with care provided in 8 intensive care
Characteristics of patients
A total of 5727 patients were admitted to the intensive care units during the period of November 1998 to March 1999. Among these, 873 (15%) patients were enrolled in the project on Care Improvement for the Critically Ill based on a positive response to 1 of 4 screening questions. Sixty-six patients (1.2%) were identified as having an iatrogenic medical event that was the primary reason for admission to the intensive care unit. A retrospective review of patient charts was performed for 64 (97%)
Discussion
Over 20 years ago, Trunet et al found that 41 (12.6%) intensive care unit admissions during a 1-year period were linked to iatrogenic medical events and, of those, 19 (46%) were preventable.13 In 1999 Darchy et al. did a retrospective review of admissions during a 1-year period to a French general hospital and found a similar percentage of admissions (68 or 10.9%) to the intensive care unit resulted from iatrogenic medical events.14 Because many errors may not be documented in the medical record
Acknowledgements
We would like to thank Eric Poon, MD, for his assistance with chart review and Jeffrey P. Burns, MD, MPH, for his comments on a draft of this manuscript.
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This study was funded by a grant from the Harvard Risk Management Foundation.