Helsinki City Health Centre, Kallio Health Station, Helsinki.
Laryngoscope. 2013 Oct;123(10):2397-400. doi: 10.1002/lary.23872. Epub 2013 Aug 5.
OBJECTIVES/HYPOTHESIS: Otorhinolaryngology (ORL) is considered a specialty associated with few serious patient injuries. Research data that support this belief are, however, scarce. We analyzed claims associated with ORL to determine the number of Finnish cases and the possible common denominators.
Register study of ORL cases in the Patient Insurance Centre (PIC), the Regional State Administrative Agencies (RSAA), and the National Supervisory Authority for Welfare and Care (Valvira) during the years 2004 to 2008.
These three agencies are the main actors in the field of patient injury in Finland. We analyzed compensated ORL patient injury cases from the PIC and cases associated with the ORL specialty for Valvira and RSAA from 2004 to 2008 and surveyed patient treatment files, statements from specialists, and compensation decisions.
Injuries were usually associated with operations; three patients who experienced injuries during these procedures died. Common ORL operations such as tonsillectomy, septoplasty, and paranasal sinus surgery were most often associated with compensated injuries. Serious injuries were few, with a total of 110 out of 422 (26.1%) claims compensated by the PIC. Of the 110 compensated cases, 30 (27.3%) were related to tumor surgery. The most usual compensated case had iatrogenic nerve injury affecting the facial or trigeminal nerves. Of the compensated cases, 79 (71.8%) were treated by specialists, 15 (13.6%) by residents, and the rest by other medical professionals.
Patient injuries in ORL are seldom severe and are strongly associated with surgery. A typical compensated injury was one that occurred in a central hospital during working hours.
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目的/假设:耳鼻喉科(ORL)被认为是与少数严重患者伤害相关的专业。然而,支持这一信念的研究数据却很少。我们分析了与 ORL 相关的索赔案例,以确定芬兰的案例数量和可能的共同因素。
2004 年至 2008 年期间,在患者保险中心(PIC)、地区国家行政机构(RSAA)和国家福利和护理监督局(Valvira)对 ORL 病例进行了注册研究。
这三个机构是芬兰患者伤害领域的主要参与者。我们分析了 PIC 中补偿性 ORL 患者伤害案例,以及 Valvira 和 RSAA 中与 ORL 专业相关的案例,并调查了患者治疗档案、专家声明和赔偿决定。
伤害通常与手术有关;在这些手术中,有三名患者受伤后死亡。常见的 ORL 手术,如扁桃体切除术、鼻中隔成形术和鼻窦手术,最常与补偿性伤害有关。严重伤害很少见,PIC 共补偿了 422 项索赔中的 110 项。在这 110 个补偿案例中,30 个(27.3%)与肿瘤手术有关。最常见的补偿案例是医源性神经损伤,影响面神经或三叉神经。在补偿案例中,79 例(71.8%)由专家治疗,15 例(13.6%)由住院医师治疗,其余由其他医疗专业人员治疗。
耳鼻喉科的患者伤害很少严重,与手术密切相关。典型的补偿性伤害是在中央医院工作时间发生的伤害。
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