Over 12,500 patients were surveyed and their Medicare claims were analyzed. Nearly 80% of patients who did not experience an AME survived to the end of the study compared to 55% of those who had AMEs. Statistical significance was not mentioned, and confidence intervals and p values were not stated.
The authors concluded that AMEs should be avoided because of the excess mortality and costs.
It is hard to argue with that, but as is true of many papers like this, the terminology changed in the body of the paper. An article about it quoted the lead author, a gerontologist, as saying, "These injuries are caused by the medical care or management rather than any underlying disease." Thus, AMEs became "injuries."
In the methods section, the authors list all of the ICD-9-CM codes included in the study.
Some of the codes are clearly preventable medical errors such as 997.02 Iatrogenic cerebrovascular infarction or hemorrhage, 998.2 Accidental puncture or laceration during a procedure, not elsewhere classified, 998.4 Foreign body accidentally left during a procedure, 998.7 Acute reaction to foreign substance accidentally left during a procedure, and the codes E870-867 "misadventures."
However, many may or may not be preventable like 997.1 Cardiac complications, not elsewhere classified, 997.31 Ventilator associated pneumonia, 997.41 Retained cholelithiasis following cholecystectomy, 998.00 Postoperative shock, unspecified, 998.30 Disruption of wound, unspecified, 998.5 Postoperative infection not elsewhere classified, and 998.83 Non-healing surgical wound.
A series of codes, E930–E949, comprises adverse drug events, most of which are not preventable.
The numbers of patients with each specific complication were not provided.
This did not stop medical news media from proclaiming more doom and gloom.
HealthDay: "1 in 5 Elderly U.S. Patients Injured by Medical Care"
WebMD: "1 in 5 elderly patients injured by medical care"
Today Topics: "Medical injuries affect almost one in five older adults in receipt of Medicare"
It is impossible to conclude from the data that all of these AMEs were caused by "medical care or management." You can quibble about whether some complications are preventable or not, but the percentage of preventable AMEs is far less than 19%.
And how many more deaths would have occurred had the patients not been subjected to "medical care or management"?
I wish people would stop writing these kinds of papers and ease off on the sensationalist reporting of them. But I guess if they did, I would have less to write about.