Iatrogenic diseases as a reason for admission to the intensive care unit -Incidence, causes, and consequences

Background: Data on iatrogenic diseases (IDs) have been recorded for the pa st 25 years. We determined whether aging of the general population and medi cal advances, including more powerful drugs and complex procedures, have al tered the incidence, causes, and consequences of severe IDs during this per iod. Methods: One-year retrospective study was conducted in an adult medical-sur gical intensive care unit (ICU) affiliated with a French general hospital i n an area of 200 000 inhabitants. All the patients admitted to the ICU duri ng 1994 were screened for IDs. Patients with community or hospital-acquired IDs on admission were included. Follow-up assessed morbidity, mortality, w orkload, and costs of care for IDs, and the rate of preventable IDs. Results: Of 623 patients admitted to the ICU, 68 (10.9%) were included; the cause of the ID was drugs in 41, medical acts in 12, and surgical acts in 15. These 68 patients were in the ICU for 472 days, with a 13% fatality rat e (9 patients) and a financial cost of US $688 470. They were not different from the 555 other ICU patients in terms of severity, mortality, workload, and length of stay in the ICU. Risk factors for ID were old age and the nu mber of prescribed drugs. The rate of preventable ID was 51%. Conclusions: Iatrogenic diseases are a persistent and important reason for admission to the ICU, and the risk factors, causes, and consequences remain unchanged since 1980. Despite 25 years of experience with high-technology medicine, ID still has a negative impact on the health and resources of soc iety.