Department of Obstetrics and Gynecology, College of Medicine, University of Illinois at Chicago, Chicago, USA.
Am J Perinatol. 2011 Dec;28(10):753-60. doi: 10.1055/s-0031-1280856. Epub 2011 Jun 22.
We sought to determine preventability for cases of obstetric hemorrhage, identify preventable factors, and compare differences between levels of hospital. We retrospectively reviewed a 1-year cohort of severe and near-miss obstetric hemorrhage in an urban perinatal network. An expert panel, using a validated preventability model, reviewed all cases. Preventability and distribution of preventability factors were compared between levels of hospital care. Sixty-three severe and near-miss obstetric hemorrhage cases were identified from 11 hospitals; 54% were deemed potentially preventable. Overall preventability was not statistically different by level of hospital, and 88% were provider related. The only treatment-related preventability factors were significantly different between levels of hospital and significantly less common in level III hospitals (p < 0.01). The majority of obstetric hemorrhage was preventable. The most common potentially preventable factor was provider treatment error, and this was significantly more common in level II hospitals. New interventions should be focused on decreasing providers' treatment errors.
我们旨在确定产科出血病例的可预防程度，确定可预防因素，并比较医院之间的差异。我们回顾性分析了城市围产期网络中为期 1 年的严重和接近发生的产科出血病例队列。一个专家小组使用经过验证的可预防模型审查了所有病例。比较了不同医院级别的可预防程度和可预防因素的分布。从 11 家医院中确定了 63 例严重和接近发生的产科出血病例；54%被认为是潜在可预防的。整体可预防程度在医院级别之间没有统计学差异，88%与提供者有关。唯一与治疗相关的可预防因素在医院级别之间存在显著差异，在三级医院中明显较少（p<0.01）。大多数产科出血是可预防的。最常见的潜在可预防因素是提供者的治疗错误，这在二级医院中更为常见。新的干预措施应侧重于减少提供者的治疗错误。
