Preventable Iatrogenic Disability in Elderly Patients During Hospitalization

Area of Science:

• Geriatric Medicine
• Patient Safety
• Healthcare Quality Improvement

Background:

• Hospitalization in older adults frequently leads to new or worsening disability.
• This disability stems from aging, frailty, comorbidities, and hospital care processes.
• Iatrogenic disability, caused by healthcare management or environment, is a significant concern.

Purpose of the Study:

• To determine the frequency of iatrogenic disability in hospitalized elderly patients.
• To identify the causes of iatrogenic disability.
• To assess the preventability of iatrogenic disability.

Main Methods:

• Included 503 patients aged 75+ hospitalized for at least 2 days.
• Defined hospitalization-associated disability as a ≥0.5 point loss in Katz ADL score.
• Expert geriatric panel reviewed charts to identify iatrogenic adverse events causing functional decline.

Main Results:

• Iatrogenic disability incidence was 11.9% (95% CI, 9.2%-15.1%).
• Of 60 cases, 81.7% were potentially preventable.
• Common causes included low mobilization (excessive bed rest, lack of PT), overuse of diapers, and urinary catheterization.

Conclusions:

• A significant portion of hospitalization-associated disability is iatrogenic and preventable.
• Healthcare professionals require education on elderly patient needs.
• Hospitalization-associated disability should be viewed as a quality of care outcome.