WARNING - a stay in hospital can kill you - inadvertently

The Sunday Telegraph reports brethlessly and in tones of shock, horror, amazement...
http://www.telegraph.co.uk/news/main.jhtml;jsessionid=O21VCMWK4D5NXQFIQMGSFFWAVCBQWIV0?xml=/news/2006/08/27/nhs27.xml

A total of 2,159 people died after serious lapses in care by hospitals, family doctors' surgeries, ambulance trusts, and in community and mental health care last year. A further 4,529 patients suffered severe harm because of avoidable mistakes, the National Patient Safety Agency (NPSA) said.

This is not news, and the levels of adverse events were known of years ago ... in fact "An annualised UK assessment indicates 5700 deaths of the 3.8 million acute hospital admissions per year"

http://www.williambowles.info/env/adverse_events.html
13/07/04 Good News on Adverse Events? By Edward Teague

1 in 10 patents entering NHS hospitals will experience an “adverse event”, and 1 in a 100 will die as a consequence writes the Editor of the British Medical Journal (BMJ) this week.

The piece also reported on ..

Now Dr Munir Pirmohamed and colleagues in Liverpool report the consequences of admitting patients suffering from adverse drug reactions (ADR) in 2 Liverpool hospitals (BMJ Vol 329 3.7.04. p. 15-19). They studied 18,820 patients admitted over a 6 month period in 2001 over 16 years old, excluding all patients with deliberate or intentional overdosing and women with obstetric or gynaecological problems, a total of 1225 admissions.

This was the largest such study undertaken in the UK

Briefly this study showed ..

1. Up to 6.5% of all admissions were related to ADRs, with a median age of 76 yrs compared with 66 yrs for all admissions and with a slight bias to females.
2. The median bed stay was 8 days or 4% of theoretical bed capacity (equivalent nationally, to seven 800 bed hospitals) involving, at average bed costs of £228 per day an annualised cost to the NHS of £466 Million.
3. 72% of the ADRs were by their definitions “avoidable”.
4. 2.3% of ADR patients died as a direct result of the ADR which is equivalent to 0.15% of all admissions, broadly equivalent to reports of US experience. An annualised UK assessment indicates 5700 deaths of the 3.8 million acute hospital admissions per year. If ADRs subsequent to admission are added, this could indicate a total greater than 10,000 deaths per year. The authors indicate that deaths resulting from ADRs not admitted to hospital in primary care are probably equivalent in number.
5. The drugs responsible are in common and widespread use and are mainly basic drugs that have been in use a long time in general practice for many common conditions and include analgesics like aspirin and Non Steroidal Anti Inflammatory Drugs (NSAIDs) like diclofenac, diuretics, steroids such as prednisolene and blood thinning warfarin. Adverse effects may result from single use or in combination.

Remarkably the 1 Mn people employed in the NHS fuck up from time to time, they are humans. As a result some people are ill, some recover, some, mainly the elderly and the very young die.

As far as can be ascertained, the rate of adverse events is roughly equivalenty in the USA and the UK, as is the rate of infection with antibiotic resistant strains of some bacteria.

The TB bacillus is becoming resistant to the armoury of antibiotics, so called Multiple Drug resistant TB MDRTB is on the increase and is prevalent inmany of the new EU states where needle exchange HIV is rampant, especially in prisons.

Not many people are taking much notice of that either. Perhaps the Sunday Telegraph will run a piece in a few years time when it has taken hold in the UK.... although there have been two major (and enormously expensive) outbreaks in London hospitals in HIV units.