Medical Centre

A recent study in Quality & Safety in Healthcare by Paul Aylin and colleagues examined death rates in patients admitted as emergencies to NHS hospitals in England. This is the largest study published on weekend mortality and highlights an area of concern in relation to the delivery of acute services. Several studies have shown higher mortality for patients admitted as emergencies at weekends compared with emergency admissions on week days. Using routinely collected hospital administrative data, they examined in-hospital deaths for all emergency inpatient admissions to all public acute hospitals in England for 2005/2006. Odds of death were calculated for admissions at the weekend compared to admissions during the week, adjusted for age, sex, socioeconomic deprivation, comorbidity and diagnosis. The overall adjusted odds of death for all emergency admissions was 10% higher in those patients admitted at the weekend compared with patients admitted during a weekday The stud...

An adverse drug reaction (ADR) is an undesirable effect of a drug beyond its anticipated therapeutic effects occurring during clinical use, and is one of the major causes of iatrogenic disease. ADRs cause significant morbidity and mortality and increase the length of hospital stays. The economic burden of ADRs on the British NHS is also high, accounting for considerable extra NHS costs. A recent study by Dr Tai-Yin Wu and colleagues published in the Journal of the Royal Society of Medicine examined hospital admissions associated with ADRs in all NHS English hospitals in the past 10 years, using the Hospital Episode Statistics database. Between 1999 and 2008, there were 557,978 ADR-associated admissions, representing 0.9% of total hospital admissions. Over this period the annual number of ADRs increased by 76.8% (from 42,453 to 75,076), and in-hospital mortality rate increased by 10% (from 4.3% to 4.7%). In 2008, there were 6,830,067 emergency admissions of which 75,076 (1.1%) were d...