Twenty four years of oral and maxillofacial surgery malpractice claims in Spain: patient safety lessons to learn
Twenty four years of oral and maxillofacial surgery malpractice claims in Spain: patient safety lessons to learn
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DOI：
10.1007/s10006-019-00756-3
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发表时间：
2019-06-01
影响因子：
1.8
通讯作者：
Arimany-Manso, Josep
中科院分区：
文献类型：
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作者：
Bordonaba-Leiva, Sergio;Gomez-Duran, Esperanza L.;Arimany-Manso, Josep
目的口腔颌面外科(OMS)的医疗事故风险是一个特别值得关注的问题，因为某些手术的美学成分和所涉及的病理复杂。本研究旨在找出职业责任索赔的相关因素，以帮助更好地管理风险，提高患者的安全。方法对加泰罗尼亚医学院理事会职业责任部门数据库中1990-2014年间开立的315项职业责任索赔进行回顾性分析，确定其临床、经济和司法特征。结果职业责任索赔的赔偿率较高(33.8%)。牙种植体手术、第三磨牙手术和鼻整形术是索赔的最大暴露，在这些病例中，牙种植体缺乏骨整合、下牙槽/舌神经神经损伤和美学效果差是最常见的补偿后遗症。统计学上，发现围手术期并发症组与PL的存在显著相关。记录不良的患者信息(知情同意书)也与PL结果显著相关。结论OMS是中等风险的索赔专业，尤其是口腔外科病例。手术并发症，如口腔/头部和颈部手术后的神经损伤和不良的美容效果，确实会发生，应该特别关注，以提高患者的安全性，以及患者信息处理程序。
PurposeOral and maxillofacial surgery (OMS) malpractice risk is of special interest due to both the aesthetic component of some procedures and the complexity of the pathologies involved. This study aims to identify relevant factors involved in OMS professional liability (PL) claims to help achive better management of risks and improve patient safety.MethodsWe performed a retrospective analysis of 315 OMS claims opened between 1990 and 2014 from the database of the PL Department of the Catalonian Council of Medical Colleges, and identified their clinical, economical and juridical characteristics.ResultsOMS showed a high rate of compensation (33.8%). Dental implant surgery, third molar surgery and rhinoplasty presented the greatest exposure to claims, and in these cases, lack of osteointegration of dental implants, neurologic injury of inferior dentoalveolar/lingual nerves and a poor aesthetic result were the most frequently compensated sequelae. Statistically, significant association was found between this perioperative complications group and the presence of PL. Poorly documented patient information (informed consent document) was also significantly related with PL outcome.ConclusionsOMS is a specialty of medium risk for claims, especially oral surgery cases. Surgical complications, such as neurologic damage after oral/head and neck procedures and poor aesthetic results, do occur and deserve special attention to improve patient safety, as well as patient-information procedure.