UK health service "harms 10 percent of patients"

Last Updated: 2006-07-06 9:59:01 -0400 (Reuters Health)

By Kate Kelland

LONDON - One in 10 patients admitted to NHS hospitals in Britain is unintentionally harmed and almost a million safety incidents, more than 2,000 of which were fatal, were recorded last year, according to a report on Thursday.

Such figures were "terrifying enough", the report by parliament's public accounts committee said, but the reality may be worse because of what it called "substantial under-reporting" of serious incidents and deaths in the NHS.

"To top it all, the NHS simply has no idea how many people die each year from patient safety incidents," Edward Leigh, the committee's chairman, said in a statement.

The committee found that some 974,000 patient safety incidents or "near misses", including 2,181 patient deaths, were recorded by the NHS but it stressed that under-reporting was a serious problem.

"(NHS) trusts estimated that on average around 22 percent of incidents and 39 percent of near misses go unreported, and that medication errors and incidents leading to serious harm are the least likely to be reported," the report said.

Leigh said the findings pointed to two "deep-seated failures": that of the NHS to secure accurate information on safety incidents and the failure "on a staggering scale" to learn from experience.

"Around 50 percent of all actual incidents might have been avoided if NHS staff had learned lessons from previous ones," Leigh said.

The report said it may take a decade or more systematically to improve safety in the NHS but that more immediate progress could be made with the introduction of electronic patient records which should reduce accidents caused by misinterpretation of doctors' handwriting.

The committee also criticized the National Patient Safety Agency, which was set up to improve safety across the National Health Service, saying there was a "question mark over the value for money" it offered.

Stephen Thornton, Chief Executive of the Health Foundation, a charity working to improve hospital safety, welcomed the committee's conclusion that more needed to be done but urged the government to provide more support.

"Hospitals need help to make sustainable, on-the-ground improvements and they need that help now," he said.

Copyright © 2006 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.

Effects of stress on heart disease still unclear

Last Updated: 2006-07-06 11:15:01 -0400 (Reuters Health)

By Maggie Fox

WASHINGTON - The death of Enron Corp. founder Kenneth Lay raises questions about the impact of his recent trial and conviction on his health, but the link between stress and heart disease is not clear-cut, experts said.

Lay, 64, died on Wednesday, six weeks after being found guilty of fraud and conspiracy in one of the biggest corporate scandals in U.S. history.

Dr. Rob Kurtzman, the forensic pathologist who performed an autopsy on Lay's body, said he died from coronary artery disease and that his examination found signs that Lay had had an earlier heart attack.

The stress of seeing the company he founded fall apart, the strain of a trial and shame of conviction could have set up a 64-year-old man with coronary artery disease for sudden death, doctors agreed.

Or he could have been overdue for a second heart attack anyway.

"People need to understand that heart disease is based on a combination of risk factors that can include your family history, your genetic risk as well as other risk factors," said Dr. Nieca Goldberg, a spokeswoman for the American Heart Association and a cardiologist at Lenox Hill Hospital in New York.

"We know that stress isn't good for your health, but in terms of its relationship to heart disease, we don't know the strength of the link the way we do about cholesterol and high blood pressure and diabetes and smoking," Goldberg said in a telephone interview.

"It is not unusual when a person has a heart attack, they have it after a sudden life-changing event. It could be loss of a spouse, loss of a house, loss of a job."

Stress can cause people to eat badly and to avoid exercise -- raising the risk of heart disease and stroke.

"Do they just have more stress and the stress causes them to do stuff that is more unhealthy ... or is it the stress directly causing the problem?" asked Dr. Chip Lavie, a cardiologist at the Ochsner Health System in New Orleans.

"The classic is a person who has a big fight with their spouse and then has a heart attack. Now that person has bad artery disease and the fight with the spouse didn't cause the bad artery disease," Lavie added in a telephone interview.

Lay had several other risk factors, such as his age.

"Stress does alter some of your risk factors for heart disease," Goldberg added. "It raises blood pressure. It also makes platelets more likely to clump together ... and blood clots do cause heart attacks. "

Scientific studies of stress and heart disease have been less than conclusive. Just last month a team at Laval University in Quebec found that job strain was linked with heart disease, but only in people in low-status jobs.

British researchers have made similar findings that suggest executives are not as subject to the health effects of stress as are workers who must follow their orders.

Heart disease is the leading cause of death in the United States, killing more than 700,000 people a year. Strokes cause another 170,000 deaths.

(Additional reporting by Bruce Nichols in Houston)

Copyright © 2006 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.