Epidemiology of Adverse Events and Medical Errors in the Care of Cardiology Patients.
Epidemiology of Adverse Events and Medical Errors in the Care of Cardiology Patients.
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DOI：
10.1097/pts.0000000000000291
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发表时间：
2019-09
影响因子：
2.2
通讯作者：
Morimoto T
中科院分区：
文献类型：
--
作者：
Ohta Y;Miki I;Kimura T;Abe M;Sakuma M;Koike K;Morimoto T
文本中提供了补充的数字内容。已经有关于普通患者不良事件(AEs)的流行病学研究，但心脏病专家护理的患者的不良事件并没有得到很好的审查。我们调查了日本成年心脏病患者的不良反应和医疗差错的发生情况。2006年2月至11月，我们对一家日语教学医院的成人门诊患者进行了横断面研究。我们从患者报告中测量了AE和ME事件，并通过医疗记录、实验室数据、事件报告和处方查询进行了验证。两名独立的医生审查了这些事件，以确定它们是AEs还是MES，并评估了严重程度和症状。我们确定了144个AEs和30个MES(每100名患者分别为16.3和3.9)。在144例不良反应中，99例为纯药物不良反应，20例为非不良反应，其余25例均为致病原因。ADE最常见的症状是皮肤和药物引起的过敏反应。非ADE最常见的症状是治疗干预引起的出血。在AEs中，12%的患者有生命危险。危及生命的不良反应占非不良反应的25%，占不良反应的5%(P=0.0003)。在30例MES中，21例(70%)与药物有关。不良事件在心脏病患者中很常见。不良反应发生率最高的不良反应是不良反应，非不良反应比不良反应更严重。这些数据应该得到执业医生的认可，以改善患者的预后。
Supplemental digital content is available in the text. There have been epidemiological studies of adverse events (AEs) among general patients but those of patients cared by cardiologist are not well scrutinized. We investigated the occurrence of AEs and medical errors (MEs) among adult patients with cardiology in Japan. We conducted a cross-sectional study of adult outpatients at a Japanese teaching hospital from February through November 2006. We measured AE and ME incidents from patient report, which were verified by medical records, laboratory data, incident reports, and prescription queries. Two independent physicians reviewed the incidents to determine whether they were AEs or MEs and to assess severity and symptoms. We identified 144 AEs and 30 MEs (16.3 and 3.9 per 100 patients, respectively). Of the 144 AEs, 99 were solely adverse drug events (ADEs), 20 were solely non-ADEs, and the remaining 25 were both causes. The most frequent symptoms of ADEs were skin and allergic reactions due to medication. The most frequent symptoms of non-ADEs were bleeding due to therapeutic interventions. Among AEs, 12% was life threatening. Life-threatening AEs were 25% of non-ADEs and 5% of ADEs (P = 0.0003). Among the 30 MEs, 21MEs (70%) were associated with drugs. Adverse events were common among cardiology patients. Adverse drug events were the most frequent AEs, and non-ADEs were more critical than ADEs. Such data should be recognized among practicing physicians to improve the patients' outcomes.