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Letters |1 May 2007

Graduate Medical Education and Patient Safety

Stephen R. Workman, MD, MSc

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
  • From Dalhousie University, Halifax, B3H 4R2 Nova Scotia, Canada.

    Potential Financial Conflicts of Interest: None disclosed.

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TO THE EDITOR:
In the case described in the recent Quality Grand Rounds article by Shojania and colleagues (1), the initial management of the patient reflects the treating clinician's understandable expectation of a rapid recovery from “mild pancreatitis.” This expectation is wrong. Pancreatitis in patients older than 65 years of age would have a statistical mortality rate of 20% (2). In patients older than 80 years, the mortality rate is probably higher—perhaps 40% (3). Usual prognostic criteria do not seem to apply to elderly patients (3, 4). Nor does resolution of pancreatitis, which occurred in this case, guarantee a good outcome. Age-adjusted mortality rates are 30 times higher in the first month after admission and 7 times higher in the second month (2).
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Workman SR. Graduate Medical Education and Patient Safety. Ann Intern Med. 2007;146:686. doi: 10.7326/0003-4819-146-9-200705010-00018

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Published: Ann Intern Med. 2007;146(9):686.

DOI: 10.7326/0003-4819-146-9-200705010-00018

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2007 American College of Physicians
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704

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