Adverse events in surgical patients in Australia
Adverse events in surgical patients in Australia
复制标题
DOI：
10.1093/intqhc/14.4.269
复制
发表时间：
2002-08-01
影响因子：
2.6
通讯作者：
Spigelman, AD
中科院分区：
文献类型：
--
作者：
Kable, AK;Gibberd, RW;Spigelman, AD
Objective.确定澳大利亚手术患者的不良事件（AE）发生率。进行了两阶段回顾性病历审查，以确定入院时AE的发生率。根据18项标准对医疗记录进行筛选，并由两名医务人员使用结构化检查表对阳性记录进行审查。1992年在澳大利亚随机选择的28家医院的住院患者。从每家医院的住院患者数据库中随机选择了520名符合条件的住院患者。共回顾了14179份病历，其中内科住院8747例，外科住院5432例。测量指标包括手术和医疗入院中AE的发生率、导致永久性残疾和死亡的比例、确定为高度可预防的比例以及与AE相关的风险因素的识别。手术入院的AE发生率为21.9%。83%的患者在12个月内残疾得到解决，13%的患者终身残疾，4%的患者死亡。审查人员发现，48%的AE是高度可预防的。不良事件的风险取决于手术，并随着年龄和住院时间的增加而增加。外科手术的高AE发生率支持监测和干预策略的必要性。18项筛选标准提供了一种工具，用于识别具有更高手术AE风险的入院。AE的风险因素为年龄和手术，应在手术前进行评估。感染和深静脉血栓形成的预防性干预可以减少医院不良事件的发生。
Objective. To determine the adverse event (AE) rate for surgical patients in Australia.Design. A two-stage retrospective medical record review was conducted to determine the occurrence of AEs in hospital admissions. Medical records were screened for 18 criteria and positive records were reviewed by two medical officers using a structured questionnaire.Setting. Admissions in 1992 to 28 randomly selected hospitals in Australia.Study participants. Five hundred and twenty eligible admissions were randomly selected from in-patient databases in each hospital. A total of 14179 medical records were reviewed, with 8747 medical and 5432 surgical admissions.Main outcome measures. Measures included the rate of AEs in surgical and medical admissions, the proportion resulting in permanent disability and death, the proportion determined to be highly preventable, and the identification of risk factors associated with AEs.Results. The AE rate for surgical admissions was 21.9%. Disability that was resolved within 12 months occurred in 83%, 13% had permanent disability, and 4% resulted in death. Reviewers found that 48% of AEs were highly preventable. The risk of an AE depended on the procedure and increased with age and length of stay.Conclusion. The high AE rate for surgical procedures supports the need for monitoring and intervention strategies. The 18 screening criteria provide a tool to identify admissions with a greater risk of a surgical AE. Risk factors for an AE were age and procedure, and these should be assessed prior to surgery. Prophylactic interventions for infection and deep vein thrombosis could reduce the occurrence of AEs in hospitals.