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[牙科创伤与麻醉学:鲁昂教学医院4年的流行病学及与保险相关的影响]

[Dental trauma and anaesthesiology: epidemiology and insurance-related impact over 4 years in Rouen teaching hospital].

作者信息

Laidoowoo E, Baert O, Besnier E, Dureuil B

机构信息

Département d'anesthésie-réanimation chirurgicale, Samu, groupe de recherche sur le handicap ventilatoire, CHU Charles-Nicolle, université de Rouen, France.

出版信息

Ann Fr Anesth Reanim. 2012 Jan;31(1):23-8. doi: 10.1016/j.annfar.2011.05.005. Epub 2011 Jul 13.

Abstract

OBJECTIVES

Dental injuries are the first cause of sinistrality in anaesthesiology. However, few insurance-related data are available concerning the publicly-owned establishments, in particular on the cost of the complaints deposited. We studied the epidemiology of dental trauma in a teaching hospital and brought it closer to the induced insurance-related costs.

PATIENTS AND METHODS

We conducted a retrospective study, examining the files of declaration of dental trauma, from January 2005 to December 2008. The litigations for dental injuries treated by Quality and Services Department were also analysed.

RESULTS

Seventy-two cases of dental lesions were declared, i.e. 1/1528 general anaesthesias. Concerning the risk factors of lesion, 47 patients (65%) presented bad dental conditions identified during the pre-anaesthetic consultation; 27 patients (37%) had criteria for difficult intubation listed on the sheet of anaesthesia. The association of the 2 factors was found among 20 patients. The indication of information to the patient on the dental risk was registered on the sheet of anaesthesia in 17% of cases. The Quality and Services Department recorded 23 complaints for dental trauma over the period. In 4 cases the complaint was followed by a compensation for an average amount equal to 608 (256-1002) Euros, i.e., a total cost of 2434 Euros.

CONCLUSIONS

The two main risk factors of dental lesion are well identified with the consultation of anaesthesia and are noted on the file. However, information to the patient on this risk is seldom notified. The incidence of dental lesions is important, but few complaints open right to financial repair for a very low insurance-related total amount.

摘要

目的

牙科损伤是麻醉学中造成医疗事故的首要原因。然而,关于公立医院,尤其是关于所提交投诉的费用,几乎没有与保险相关的数据。我们研究了一家教学医院牙科创伤的流行病学情况,并将其与引发的保险相关费用进行了对比。

患者与方法

我们进行了一项回顾性研究,查阅了2005年1月至2008年12月期间牙科创伤申报文件。还分析了质量与服务部门处理的牙科损伤诉讼案件。

结果

共申报了72例牙损伤病例,即占全身麻醉病例的1/1528。关于损伤的风险因素,47例患者(65%)在麻醉前会诊时被发现存在牙齿状况不佳的情况;27例患者(37%)在麻醉记录单上列出了存在困难插管的标准。20例患者同时存在这两种因素。在17%的病例中,麻醉记录单上记录了向患者告知牙科风险的情况。质量与服务部门在该期间记录了23起牙科创伤投诉。其中4起投诉之后获得了赔偿,平均赔偿金额为608(256 - 1002)欧元,即总费用为2434欧元。

结论

通过麻醉会诊能够很好地识别出牙损伤的两个主要风险因素,并记录在档案中。然而,很少向患者告知这种风险。牙损伤的发生率较高,但很少有投诉能获得经济赔偿,且与保险相关的赔偿总额非常低。

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