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重症监护病房不良事件和医疗差错的结局:一项系统评价和荟萃分析。

Outcome of adverse events and medical errors in the intensive care unit: a systematic review and meta-analysis.

作者信息

Ahmed Adil H, Giri Jyothsna, Kashyap Rahul, Singh Balwinder, Dong Yue, Kilickaya Oguz, Erwin Patricia J, Murad M Hassan, Pickering Brian W

机构信息

Mayo Clinic, Rochester, MN

Mayo Clinic, Rochester, MN.

出版信息

Am J Med Qual. 2015 Jan-Feb;30(1):23-30. doi: 10.1177/1062860613514770. Epub 2013 Dec 19.

Abstract

Adverse events and medical errors (AEs/MEs) are more likely to occur in the intensive care unit (ICU). Information about the incidence and outcomes of such events is conflicting. A systematic review and meta-analysis were conducted to examine the effects of MEs/AEs on mortality and hospital and ICU lengths of stay among ICU patients. Potentially eligible studies were identified from 4 major databases. Of 902 studies screened, 12 met the inclusion criteria, 10 of which are included in the quantitative analysis. Patients with 1 or more MEs/AEs (vs no MEs/AEs) had a nonsignificant increase in mortality (odds ratio = 1.5; 95% confidence interval [CI] = 0.98-2.14) but significantly longer hospital and ICU stays; the mean difference (95% CI) was 8.9 (3.3-14.7) days for hospital stay and 6.8 (0.2-13.4) days for ICU. The ICU environment is associated with a substantial incidence of MEs/AEs, and patients with MEs/AEs have worse outcomes than those with no MEs/AEs.

摘要

不良事件和医疗差错(AEs/MEs)在重症监护病房(ICU)更易发生。关于此类事件的发生率和结局的信息相互矛盾。进行了一项系统评价和荟萃分析,以研究医疗差错/不良事件对ICU患者死亡率、住院时间和ICU住院时间的影响。从4个主要数据库中识别出潜在符合条件的研究。在筛选的902项研究中,12项符合纳入标准,其中10项纳入定量分析。发生1次或更多次医疗差错/不良事件的患者(与未发生医疗差错/不良事件的患者相比)死亡率虽有非显著增加(比值比=1.5;95%置信区间[CI]=0.98 - 2.14),但住院时间和ICU住院时间显著更长;住院时间的平均差值(95%CI)为8.9(3.3 - 14.7)天,ICU住院时间的平均差值(95%CI)为6.8(0.2 - 13.4)天。ICU环境与医疗差错/不良事件的高发生率相关,发生医疗差错/不良事件的患者比未发生此类事件的患者结局更差。

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