Tue
Oct 7, 4:00 PM ET
By LINDSEY TANNER, AP Medical Writer
CHICAGO
- Postoperative infections, surgical wounds accidentally opening
and other often-preventable complications lead to more than
32,000 U.S. hospital deaths and more than $9 billion in extra
costs annually, a report suggests.
Researchers from the U.S. government's Agency for Healthcare
Research analyzed data on 18 complications sometimes caused
by medical errors. They found that such complications contribute
to 2.4 million extra days in the hospital each year.
The findings greatly underestimate the problem, since many
other complications happen that are not listed in hospital
administrative data, the researchers said.
The study follows a 1999 Institute of Medicine (news - web
sites) report that said medical mistakes kill anywhere from
44,000 to 98,000 hospitalized Americans a year. That report
focused national attention on the problem and led to numerous
recommendations for improving safety.
The new report, based on data from 994 hospitals nationwide
in 2000, provides a more detailed look at specific complications
and the costs associated with each one.
Many of the 18 complications, including medical objects left
inside patients after surgery, are preventable medical errors.
Some, like bleeding after surgery, might not always be avoidable,
said Dr. Chunliu Zhan of the U.S. Agency for Healthcare Research
and Quality. Zhan did the research with Dr. Marlene Miller,
now at Johns Hopkins Children's Center.
The study was published in Wednesday's Journal of the American
Medical Association (news - web sites).
"Given their staggering magnitude, these estimates are clearly
sobering," Drs. Saul Weingart and Lisa Iezzoni of Harvard's
Beth Israel Deaconess Medical Center said in an accompanying
editorial.
The most serious complication was post-surgery sepsis — bloodstream
infections — which occurred in 2,592 patients. Sepsis resulted
in 11 extra days of hospitalization and $57,727 in extra costs
per patient, plus a 22 percent higher risk of death.
Improved medical practices, including an emphasis on better
hand-washing, might help reduce the rates, Zhan said.
Surgical wound openings were the second most serious complication,
resulting in nine extra days of hospitalization, $40,323 in
extra costs and a nearly 10 percent higher death rate.
Zhan said the figures do not capture all complication-related
costs.
For example, one common injury — trauma during vaginal childbirth
without use of forceps or other instruments — resulted in
virtually no extra hospitalization costs or deaths but probably
led to other complications in mothers or their infants, the
researchers said. There were 51,223 such injuries studied.
Zhan said his study does not answer whether progress has been
made since the 1999 Institute of Medicine report.
His agency is among many working on reducing medical errors
and complications. Among other things, the agency recently
developed a fact sheet listing steps patients can take to
get safer treatment, including questioning doctors about what
to expect from surgery and asking about which hospital would
be best for their particular condition.
On the Net:
JAMA: http://jama.ama-assn.org
Agency for Healthcare Research and Quality: http://www.ahrq.gov
CHICAGO
- Postoperative infections, surgical wounds accidentally opening
and other often-preventable complications lead to more than
32,000 U.S. hospital deaths and more than $9 billion in extra
costs annually, a report suggests. 
