Ahmed Adil H, Giri Jyothsna, Kashyap Rahul, Singh Balwinder, Dong Yue, Kilickaya Oguz, Erwin Patricia J, Murad M Hassan, Pickering Brian W
Mayo Clinic, Rochester, MN
Mayo Clinic, Rochester, MN.
Am J Med Qual. 2015 Jan-Feb;30(1):23-30. doi: 10.1177/1062860613514770. Epub 2013 Dec 19.
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.
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。
