We found that 36% of 815 consecutive patients on a general medical service of a university hospital had an iatrogenic illness. In 9% of all persons admitted, the incident was considered major in that it threatened life or produced considerable disability. In 2% of the 815 patients, the iatrogenic illness was believed to contribute to the death of the patient. Exposure to drugs was a particularly important factor in determining which patients had complications. Given the increasing number and complexity of diagnostic procedures and therapeutic agents, monitoring of untoward events is essential, and attention should be paid to educational efforts to reduce the risks of iatrogenic illness.
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[Abstract][Full Text]
Healey, M. A., Shackford, S. R., Osler, T. M., Rogers, F. B., Burns, E.
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583: 29-43
[Abstract]
Agostini, J. V., Leo-Summers, L. S., Inouye, S. K.
(2001). Cognitive and Other Adverse Effects of Diphenhydramine Use in Hospitalized Older Patients. Arch Intern Med
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[Abstract][Full Text]
Conry, J. M.
(2000). Significant Drug Interactions in the HIV Patient. Journal of Pharmacy Practice
13: 499-514
[Abstract]
Wolfe, A., Oh, J.
(2000). Health Care Errors: A Perspective on the Problem. Policy Politics Nursing Practice
1: 213-218
[Abstract]
Bedell, S. E., Jabbour, S., Goldberg, R., Glaser, H., Gobble, S., Young-Xu, Y., Graboys, T. B., Ravid, S.
(2000). Discrepancies in the Use of Medications: Their Extent and Predictors in an Outpatient Practice. Arch Intern Med
160: 2129-2134
[Abstract][Full Text]
Thomas, E. J, Brennan, T. A
(2000). Incidence and types of preventable adverse events in elderly patients: population based review of medical records. BMJ
320: 741-744
[Abstract][Full Text]
Weingart, S. N, Wilson, R. M., Gibberd, R. W, Harrison, B.
(2000). Epidemiology of medical error. BMJ
320: 774-777
[Full Text]
Bates, D. W., Miller, E. B., Cullen, D. J., Burdick, L., Williams, L., Laird, N., Petersen, L. A., Small, S. D., Sweitzer, B. J., Vander Vliet, M., Leape, L. L., for the ADE Prevention Study Group,
(1999). Patient Risk Factors for Adverse Drug Events in Hospitalized Patients. Arch Intern Med
159: 2553-2560
[Abstract][Full Text]
Godje, O., Lamm, P., Adelhard, K., Schutz, A., Kilger, E., Gotz, A., Lange, T., Mair, H., Reichart, B.
(1999). Surgical versus medical care for postoperative cardiac surgical patients at the general ward. Eur. J. Cardiothorac. Surg.
16: 222-227
[Abstract][Full Text]
Darchy, B., Le Miere, E., Figueredo, B., Bavoux, E., Domart, Y.
(1999). Iatrogenic Diseases as a Reason for Admission to the Intensive Care Unit: Incidence, Causes, and Consequences. Arch Intern Med
159: 71-78
[Abstract][Full Text]
Brown, G. E.
(1998). Redesign for Effective Quality Assurance: Pilot Program in an Urban Community Hospital. American Journal of Medical Quality
13: 141-146
[Abstract]
Lazarou, J., Pomeranz, B. H., Corey, P. N.
(1998). Incidence of Adverse Drug Reactions in Hospitalized Patients: A Meta-analysis of Prospective Studies. JAMA
279: 1200-1205
[Abstract][Full Text]
Hay, J. A., Maldonado, L., Weingarten, S. R., Ellrodt, A. G.
(1997). Prospective Evaluation of a Clinical Guideline Recommending Hospital Length of Stay in Upper Gastrointestinal Tract Hemorrhage. JAMA
278: 2151-2156
[Abstract]
Lesar, T. S., Lomaestro, B. M., Pohl, H.
(1997). Medication-Prescribing Errors in a Teaching Hospital: A 9-Year Experience. Arch Intern Med
157: 1569-1576
[Abstract]
Casarett, D., Ross, L. F.
(1997). Overriding a Patient's Refusal of Treatment after an Iatrogenic Complication. NEJM
336: 1908-1910
[Full Text]
Castle, N. G., Mor, V.
(1996). Hospitalization of Nursing Home Residents: A Review of the Literature, 1980-1995. Med Care Res Rev
53: 123-148
[Abstract]
Sager, M. A., Franke, T., Inouye, S. K., Landefeld, C. S., Morgan, T. M., Rudberg, M. A., Siebens, H., Winograd, C. H.
(1996). Functional Outcomes of Acute Medical Illness and Hospitalization in Older Persons. Arch Intern Med
156: 645-652
[Abstract]
Inouye, S. K., Charpentier, P. A.
(1996). Precipitating Factors for Delirium in Hospitalized Elderly Persons: Predictive Model and Interrelationship With Baseline Vulnerability. JAMA
275: 852-857
[Abstract]
Jain, P., Parada, J. P., David, A., Smith, L. G.
(1995). Overuse of the Indwelling Urinary Tract Catheter in Hospitalized Medical Patients. Arch Intern Med
155: 1425-1429
[Abstract]
Kalish, R. L., Daley, J., Duncan, C. C., Davis, R. B., Coffman, G. A., Iezzoni, L. I.
(1995). Costs of Potential Complications of Care for Major Surgery Patients. American Journal of Medical Quality
10: 48-54
[Abstract]
Hull, R. D., Raskob, G. E., Pineo, G. F., Brant, R. F.
(1995). The Treatment of Proximal Vein Thrombosis with Subcutaneous Low-Mole Molecular-Weight Heparin Compared with Continuous Intravenous Heparin. CLIN APPL THROMB HEMOST
1: 151-159
[Abstract]
Leape, L. L.
(1994). Error in Medicine. JAMA
272: 1851-1857
[Abstract]
Faden, A. I., Sharpe, V. A.
(1994). Iatrogenic Neurological Complications. Arch Neurol
51: 1184-1185
[Abstract]
Rosenthal, G. E., Landefeld, C. S.
(1993). Do Older Medicare Patients Cost Hospitals More? Evidence From an Academic Medical Center. Arch Intern Med
153: 89-96
[Abstract]
Chrischilles, E. A., Segar, E. T., Wallace, R. B.
(1992). Self-Reported Adverse Drug Reactions and Related Resource Use: A Study of Community-Dwelling Persons 65 Years of Age and Older. ANN INTERN MED
117: 634-640
[Abstract]
Lefevre, F., Feinglass, J., Potts, S., Soglin, L., Yarnold, P., Martin, G. J., Webster, J. R.
(1992). Iatrogenic Complications in High-Risk, Elderly Patients. Arch Intern Med
152: 2074-2080
[Abstract]
Hickson, G. B., Clayton, E. W., Githens, P. B., Sloan, F. A.
(1992). Factors That Prompted Families to File Medical Malpractice Claims Following Perinatal Injuries. JAMA
267: 1359-1363
[Abstract]
Brennan, T. A., Hebert, L. E., Laird, N. M., Lawthers, A., Thorpe, K. E., Leape, L. L., Localio, A. R., Lipsitz, S. R., Newhouse, J. P., Weiler, P. C., Hiatt, H. H.
(1991). Hospital Characteristics Associated With Adverse Events and Substandard Care. JAMA
265: 3265-3269
[Abstract]
Bedell, S. E., Deitz, D. C., Leeman, D., Delbanco, T. L.
(1991). Incidence and Characteristics of Preventable latrogenic Cardiac Arrests. JAMA
265: 2815-2820
[Abstract]
Schiff, G. D., Hegde, H. K., LaCloche, L., Hryhorczuk, D. O.
(1991). Inpatient Theophylline Toxicity: Preventable Factors. ANN INTERN MED
114: 748-753
[Abstract]
(1990). American Medical Association White Paper on Elderly Health: Report of the Council on Scientific Affairs. Arch Intern Med
150: 2459-2472
[Abstract]
Lesar, T. S., Briceland, L. L., Delcoure, K., Parmalee, J. C., Masta-Gornic, V., Pohl, H.
(1990). Medication Prescribing Errors in a Teaching Hospital. JAMA
263: 2329-2334
[Abstract]
Soumerai, S. B., Ross-Degnan, D., Gortmaker, S., Avorn, J.
(1990). Withdrawing Payment for Nonscientific Drug Therapy: Intended and Unexpected Effects of a Large-Scale Natural Experiment. JAMA
263: 831-839
[Abstract]
Ouslander, J. G.
(1989). Medical Care in the Nursing Home. JAMA
262: 2582-2590
[Abstract]
Schroeder, S. A., Zones, J. S., Showstack, J. A.
(1989). Academic Medicine as a Public Trust. JAMA
262: 803-812
[Abstract]
Middleton, K., Clarke, E., Homann, S., Naughton, B., Neely, D., Repasy, A., Yarnold, P. R., Yungbluth, M., Webster, J. R. Jr
(1989). An Autopsy-Based Study of Diagnostic Errors in Geriatric and Nongeriatric Adult Patients. Arch Intern Med
149: 1809-1812
[Abstract]
German, P. S., Burton, L. C.
(1989). Medication and the Elderly: Issues of Prescription and Use. J Aging Health
1: 4-34
[Abstract]
McPherson, M. L.
(1989). Medicating the elderly in home health care. Home Health Care Management Practice
2: 16-28
[Abstract]
Savitsky, M. E.
(1989). Recognizing Hospital Adverse Drug Reactions. Journal of Pharmacy Practice
2: 203-208
[Abstract]
Barry, P. P., Moskowitz, M. A.
(1988). The Diagnosis of Reversible Dementia in the Elderly: A Critical Review. Arch Intern Med
148: 1914-1918
[Abstract]
LARSON, E. B., KUKULL, W. A., BUCHNER, D., REIFLER, B. V.
(1987). Adverse Drug Reactions Associated with Global Cognitive Impairment in Elderly Persons. ANN INTERN MED
107: 169-173
[Abstract]
Ives, T. J., Bentz, E. J., Gwyther, R. E.
(1987). Drug-Related Admissions to a Family Medicine Inpatient Service. Arch Intern Med
147: 1117-1120
[Abstract]
Becker, P. M., McVey, L. J., Saltz, C. C., Feussner, J. R., Cohen, H. J.
(1987). Hospital-Acquired Complications in a Randomized Controlled Clinical Trial of a Geriatric Consultation Team. JAMA
257: 2313-2317
[Abstract]
Campion, E. W.
(1987). The Merits of Geriatric Consultation. JAMA
257: 2336-2337
[Abstract]
Applegate, W. B.
(1986). Physician Management of Patients With Adverse Outcomes. Arch Intern Med
146: 2249-2252
[Abstract]
Lakshmanan, M. C., Hershey, C. O., Breslau, D.
(1986). Hospital Admissions Caused by Iatrogenic Disease. Arch Intern Med
146: 1931-1934
[Abstract]
Parrino, T. A., Villanueva, A. G.
(1986). The Principles and Practice of Morning Report. JAMA
256: 730-733
[Abstract]
Richards, E. P., Rathbun, K. C.
(1986). Legal Issues in Critical Care Medicine. J Intensive Care Med
1: 101-110
[Abstract]
Press, I.
(1984). The Predisposition to File Claims: The Patient's Perspective. J Law Med Ethics
12: 53-62
DeAngelis, C., Joffe, A., Wilson, M., Willis, E.
(1983). Iatrogenic Risks and Financial Costs of Hospitalizing Febrile Infants. Arch Pediatr Adolesc Med
137: 1146-1149
[Abstract]
Warshaw, G. A., Moore, J. T., Friedman, S. W., Currie, C. T., Kennie, D. C., Kane, W. J., Mears, P. A.
(1982). Functional Disability in the Hospitalized Elderly. JAMA
248: 847-850
[Abstract]
Anderson, R. J., Melikian, D. M., Gambertoglio, J. G., Berns, A. S., Cadnapaphornchai, P., Egan, D. J., Goldberg, J. P., Henrich, W. L., Hicks, D. L., Kovalchik, M. T., Olin, D. B.
(1982). Prescribing Medication in Long-term Dialysis Units. Arch Intern Med
142: 1305-1308
[Abstract]
Campion, E. W., Mulley, A. G., Goldstein, R. L., Barnett, G. O., Thibault, G. E.
(1981). Medical Intensive Care for the Elderly: A Study of Current Use, Costs, and Outcomes. JAMA
246: 2052-2056
[Abstract]