Davenport María C, Domínguez Paula A, Ferreira Juan P, Kannemann Ana L, Paganini Agustina, Torres Fernando A
Hospital General de Niños Pedro de Elizalde.
Arch Argent Pediatr. 2017 Aug 1;115(4):357-363. doi: 10.5546/aap.2017.eng.357.
The safety of inpatients is a priority in the health care system. The Global Trigger Tool seems to be suitable to estimate the incidence of adverse events (AE) in pediatric inpatients.
To describe the incidence and categories of AE in pediatric inpatients using the Global Trigger Tool and to identify risk factors associated to their development.
Retrospective study. Medical records of 200 patients hospitalized at Hospital Elizalde during 2013 were included. Outcome measures: number of AE/100 admissions and distribution of harm. A chi² test, Student´s t test and Pearson's correlation test were carried out. Significance level = p < 0.05.
The study detected 289 triggers (1.4/patient); 52 AEs (26 AEs/100 patients, 95% CI: 20.4-32.5). There was at least one AE every 36 patients; 7 patients had more than one AE; 45 AEs were in the E and F categories (temporary harm). Medical care triggers were associated to AEs (OR 8.1; 95% CI: 3.7-17.3, p < 0.001). A positive correlation was found between the number of triggers and the number of AEs per patient (R= 0.46; p < 0.001). Being hospitalized in a closed unit (OR 2.8; 95% CI: 1.2-6.5; p= 0.03) and a longer hospital stay were associated to AEs (p < 0.001).
An AE frequency of 26% was identified, and most AEs resulted in temporary harm. The presence of AEs was associated to hospitalization in a closed unit, longer hospital stay, higher number of triggers and general care triggers.
住院患者的安全是医疗保健系统中的首要任务。全球触发工具似乎适用于估计儿科住院患者中不良事件(AE)的发生率。
使用全球触发工具描述儿科住院患者中AE的发生率和类别,并确定与其发生相关的风险因素。
回顾性研究。纳入了2013年在伊丽莎白医院住院的200例患者的病历。观察指标:每100次入院的AE数量及伤害分布。进行了卡方检验、学生t检验和皮尔逊相关检验。显著性水平=p<0.05。
该研究检测到289个触发因素(1.4个/患者);52例AE(26例AE/100例患者,95%可信区间:20.4 - 32.5)。每36例患者中至少有1例AE;7例患者有不止1例AE;45例AE属于E类和F类(暂时性伤害)。医疗护理触发因素与AE相关(比值比8.1;95%可信区间:3.7 - 17.3,p<0.001)。触发因素数量与每位患者的AE数量之间存在正相关(R = 0.46;p<0.001)。在封闭式病房住院(比值比2.8;95%可信区间:1.2 - 6.5;p = 0.03)以及住院时间较长与AE相关(p<0.001)。
确定了AE发生率为26%,且大多数AE导致暂时性伤害。AE的发生与在封闭式病房住院、住院时间较长、触发因素数量较多以及一般护理触发因素有关。