The epidemiology of Iatrogenic Diseases in seniors

June 2, 2016

Iatrogenic Diseases are the ones that are caused by the medical treatment and are generally the result of the diagnostic and the therapeutic procedures conducted on a patient.  It is “any illness resulting from a diagnostic procedure or from any form of therapy or a harmful event that is not a natural consequence of the patient’s disease”.

“Iatrogenic disability” is related to a cascade of events or procedures set off by the acute illness and hospitalization, and that has damaging effects on the patient’s functional status. With the multitude of drugs prescribed to a single patient, the chances of adverse drug reactions are bound to skyrocket. An iatrogenic pathology in the elderly population has a far bigger impact, partly due to an increased elderly population percentage and also because of an increased prevalence of iatrogenic pathology with age. The greater the number of chronic diseases, the higher the chances of risks that treatment of one disease can exacerbate others. imageO36For example, treatment of arthritis with an NSAID (Non-steroidal anti-inflammatory drugs) may lead to a heart failure, coronary artery disease, or chronic gastritis. As such, the projected statistic of 7.8 million iatrogenic deaths is more than all the casualties from all the wars that the US has fought in its entire history.

Iatrogenesis (in Greek is “brought forth by the healer”) refers to any effect on a person, resulting from any activity of one or more persons acting as healthcare professionals or promoting products or services as beneficial to health, that does not fulfill the goal of the person affected. Although an iatrogenic disease is not always harmful to the patient, nevertheless it claims to cost at least 230,000 lives each year in the U.S. alone. In the past ten years, approximately 164 million people have been treated unnecessarily by the medical industry – that is equal to around 50,000 people per day. According to The National Health Expenditure Accounts (NHEA), at 17.5% of the Gross National Product, healthcare spending reached around $3.0 trillion in 2014. Considering this enormous expenditure, the US should have the best medicine in the world. We should be reversing disease, preventing disease, and doing minimal harm.

However, a careful and objective review shows exactly the opposite. The group that has been hit the most is – the elderly and the seniors. They already seem to be affected by a number of chronic diseases, and as such they are more prone to being at a greater risk of being affected by other diseases, as a result of the treatment of one disease. If they get sicker after receiving some type of medical treatment that was supposed to make them feel better, then this is called an iatrogenic diseaseThese diseases could be more of an effect or a symptom than a full-on disease.
Risk factors for Iatrogenic diseases.001A complication after surgery or another medical procedure could be classified as an Iatrogenic Disease that could be a result of error or negligence on the part of the surgeon, doctor, nurse, or pharmacist, or it could simply be due to chance (when no one is at fault, but complications just happen).

Although the epidemiology of iatrogenic diseases in the elderly has not been extensively reported, they are one of the leading causes of death and illnesses among seniors. It develops as a result of another form of medical treatment or advice provided to a patient. It can also be because of complications after surgery or another medical treatment, or due to indirect interactions from medications or drug therapy.

As few as 5% and only up to 20% of iatrogenic acts are ever reported. This implies that if medical errors were completely and accurately reported, we would have a much higher annual iatrogenic death rate.  In 1994, a gerontologist Dr. Leape stated that as many as 180,000 medical mistakes annually was equivalent to three jumbo-jet crashes every two days. But a recent report shows that the number has reached up to six jumbo jets that are falling from the sky each and every day.

Some iatrogenic effects are clearly defined and easily recognized, such as a complication following a surgical procedure (e.g., lymphedema as a result of breast cancer surgery). But the less obvious ones are complex drug interactions, that may require significant investigation to identify.

The 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 making an immense progress with high-technology medicine, the iatrogenic complications still have a large negative impact on the health and resources of the society. Iatrogenic complications are life-threatening in 10% to 26% of cases.

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