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The incidence of iatrogenic deaths in the Finnish cause-of-death statistics; a retrospective study
Paula Kuvaja1, Noora Keinänen1, Lasse Pakanen2
1Forensic Medicine Unit, Finnish Institute for Health and Welfare (THL), P.O. Box 310, FI-90101, Oulu, Finland.
Purpose:
An adverse event in health care leading to death is a significant event when assessing patient safety. This study was designed in order to assess, how many iatrogenic deaths are registered in Finland annually, and what type of treatment they are mostly related to.
Methods:
Material was collected using cause of death-statistics that includes "manner of death"-classification in Finland in 2014-2015.
Results:
There were 350 cases that met the criteria of the study. In a majority of the cases (264, 75%), a medico-legal autopsy was performed. This represents only 1.4% of all medicolegal autopsies during the study period in Finland. The cases were most often related to medication (30%) or known high-risk procedures such as gastrointestinal surgery (23%) and cardiothoracic surgery (11%). Only 12% of the cases had no prior significant medical history. Patient characteristics were somewhat different among the surgical disciplines, probably reflecting treatment practices.
Conclusion:
Deaths that are classified as iatrogenic are mostly related to known high-risk surgery or medication. Further studies are needed to assess the true incidence of malpractice among this material.
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