http://news.com.au/common/story_page/0,4057,3882580%255E421,00.html

 

Epidemic of errors kills aged
By John Kerin
The Australian
04mar02

A SILENT epidemic of errors in surgery and treatment in teaching hospitals is claiming lives of the elderly.

A new study suggests as many as one in five patients over 75 who have unscheduled operations are subjected to errors either in surgery or in post-operative treatment. A further 14 per cent die because of such mistakes.

The highest error rate was associated with heart surgery, at 20 per cent, while the lowest was plastic surgery with an error rate of 9.6 per cent.

"In our view there is a silent epidemic which requires urgent and systematic attention," says study author Rinaldo Bellomo, director of intensive care research at the Austin and Repatriation Medical Centre in Melbourne.

Dr Bellomo's team looked at 1125 patients who had undergone in-patient surgery at the centre between December 1998 and March 1999.

In this group, the researchers found 190 patients experienced 414 mistakes leading to outcomes such as cardiac arrest, respiratory failure and acute kidney failure.

Eighty of the patients died as a result of the errors.

The study found the incidence of errors was particularly high among the over-75s.

Out of 262 patients over the age of 75 where there was no admission to an intensive care unit, 59 – or 22.5 per cent – experienced an error and 37 – or 14 per cent – died.

And of 135 patients over 75 years having unscheduled surgery, 27 – or 20 per cent – died as a result.

Six out of nine patients over 92 years of age having hip surgery also died.

"Our study could not address the cause of the serious adverse events (with the factors) likely to be extremely complex," Dr Bellomo says.

"Our findings suggest there is much scope for improving care in our tertiary hospitals."

The study says adverse events are common among patients having in-patient surgery in a teaching hospital.

"They are particularly common in the elderly and in those having unscheduled surgery."

But Australian Medical Association vice-president Trevor Mudge said the findings should be treated with caution.

"It doesn't mean we don't have to continue to strive to reduce errors and adverse events in hospitals, but you have to be careful about studies in the elderly because almost by definition the death-rate will be high," Mr Mudge said.

"Complications from hip replacement surgery and pneumonia are common causes of death among the elderly. especially

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