Iatrogenic Complications in High-Risk, Elderly Patients

Lefèvre, Frank; Feinglass, Joseph; Potts, Steven; Soglin, Lenore F; Yarnold, Paul R.; Martin, Gary J.; Webster, James R.

doi:10.1001/archinte.1992.00400220090016

Cited by 98 publications

(57 citation statements)

References 26 publications

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“…Lefèvre e col. 19 (1992) analisaram a incidência de manifestações iatrogênicas em 120 pacientes com idade igual ou superior a 65 anos, internados em hospital universitário, verificando que 70 (58,3%) apresentaram uma ou mais manifestações e 43 (35,8%) apresentaram complicação iatrogênica rotulada como potencialmente evitável.…”

Section: Discussionunclassified

Iatrogenia em pacientes idosos hospitalizados

et al. 1998

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Analisar as complicações iatrogênicas apresentadas por idosos hospitalizados. Estudo retrospectivo dos prontuários de 96 pacientes, 48 do sexo masculino e 48 do feminino, com idades variando de 60 a 93 anos (média: 75,7 anos), hospitalizados durante o ano de 1995 em enfermaria geriátrica. A análise da evolução dos pacientes durante o período de hospitalização permitiu evidenciar: 1) em 42 (43,7%) pacientes ocorreram uma ou mais complicações iatrogênicas, num total de 56 episódios; 2) manifestações relacionadas aos procedimentos diagnósticos corresponderam a 17,9% das iatrogenias; 3) alterações relacionadas às medidas terapêuticas corresponderam a 58,9%, sendo 32,1% referentes à terapêutica farmacológica e 26,8% a outros procedimentos terapêuticos; 4) manifestações iatrogênicas não relacionadas diretamente às afecções (úlceras de decúbito, quedas e fraturas) corresponderam a 23,2%; 5) a presença de manifestações iatrogênicas correlacionou-se com período mais prolongado de internação; 6) cinco pacientes faleceram em conseqüência direta de complicações iatrogênicas. A iatrogenia é freqüente em pacientes idosos hospitalizados, podendo determinar manifestações graves e mesmo fatais. Como uma significativa proporção dessas complicações pode ser evitada através de medidas adequadas, deve-se procurar identificar suas causas e desenvolver métodos para previni-la ou reduzir seus efeitos.

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Section: Discussionunclassified

Iatrogenia em pacientes idosos hospitalizados

et al. 1998

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“…The most common cause of iatrogenic conditions in the older people are related to medication. Older people admitted for longer than 15 days were reported to have iatrogenic misadventures in up to 58%, and 61% of these were preventable [4]. Beijer and de Blaey estimated that older patients are 4 times more likely to be hospitalized for a medication mishap than those younger than 65 years of age [5].…”

Section: Brief Communication (Original)mentioning

confidence: 99%

Medication nonadherence in elderly patients in a Thai geriatric clinic

et al. 2014

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Background: Medication nonadherence is common in elderly patients and is a major cause of morbidity. However, it is not well-described in the literature and to our knowledge has never been studied in Thais. Objective: To investigate the extent, causes, and contributing factors of medication nonadherence in older patients in a geriatric clinic. Material and Methods: We conducted a cross-sectional study at Siriraj Hospital, a university teaching hospital in Bangkok. We assessed baseline demographic data, comorbid diseases, Thai Mental State Examination (TMSE), functional status (basic and basic activities of daily living), type and number of medications used, and medication adherence. Results: There were 153 participants in this study. Medication nonadherence, in the administration of prescribed drugs only, was found in 34% of the participants. Nonadherence to administration of prescribed drugs and to the advice regarding over-the-counter drugs was 42.5%. Nonadherence to the administration of prescribed drugs and to the advice regarding over-the-counter drugs, and herbal and dietary supplements was 54.9%. Three most common causes of medication nonadherence were misunderstanding or lack of the knowledge (25.6%), the development of adverse drug events (18.9%), and because of a suggestion by a friend or family member (16.2%). Conclusion: Medication nonadherence is common in elderly Thais attending geriatric clinics. We recommend clinicians be aware of this problem and develop a system to improve medication adherence. The clarification of reasons for prescribing is crucial. We recommend emphasis on educating patients, family members, and the public about the risk of nonadherence and of using nonprescribed medications.

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“…[55][56][57] In the Harvard Medical Practice Study, a retrospective study of adverse events in 30,000 patients, those age 65 and over accounted for 27% of the hospitalized population but 43% of the adverse events. In this study, four types of adverse events occurred at least twice as often in older patients: fractures, falls, nontechnical postoperative complications, and adverse events related to noninvasive treatments.…”

Section: Frail Elderly Patients Are At High Risk For Iatrogenic Complmentioning

confidence: 99%

Ten ways to improve the care of elderly patients in the hospital

Labella

Merel

Phelan

2011

Journal of Hospital Medicine

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Hospitalists care for elderly patients daily, but few have specialized training in geriatric medicine. Elderly patients, and in particular the very old and the frail elderly, are at high risk of functional decline and iatrogenic complications during hospitalization. Other challenges in caring for this patient population include dosing medications safely, preventing delirium and accidental falls, and providing adequate pain control. Ways to improve the care of the hospitalized elderly patient include the following: screening for geriatric syndromes such as delirium, assessing functional status and maintaining mobility, and implementation of interventions that have been shown to prevent delirium, accidental falls, and acute functional decline in the hospital. This article addresses these issues with 10 evidence‐based pearls developed to help hospitalists provide optimal care for this expanding population. Journal of Hospital Medicine 2011;6:351–357. © 2011 Society of Hospital Medicine

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Iatrogenic Complications in High-Risk, Elderly Patients

Cited by 98 publications

References 26 publications

Iatrogenia em pacientes idosos hospitalizados

Iatrogenia em pacientes idosos hospitalizados

Medication nonadherence in elderly patients in a Thai geriatric clinic

Ten ways to improve the care of elderly patients in the hospital

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