In this issue, members of the Boston Collaborative Drug Surveillance Program report on 24 drug-related deaths in hospitalized medical patients. The five-year study monitored more than 26,000 acutely ill patients, spanning seven countries. In this sense, the report represents an overview of therapeutic practices, and their attendant hazards, in the Western world.
A death rate of nearly one per thousand (0.9 per 1,000, to be exact) may seem disquietingly high at first sight. A closer look at the study protocol, however, makes it clear that the outlook isn't all that bleak. For one, the five deaths from intravenous fluid overload weight the data unfavorably, inasmuch as the drug (ie, water plus additives) is less at fault than the mode of administration (ie, too much, too fast).
Then too, the majority of drug-related deaths occurred in patients so sick as to require hospital admission; and of these, most were severely or
de Jong RH. Drug-Related Deaths. JAMA. 1977;237(9):898. doi:10.1001/jama.1977.03270360060023
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