Department of Nutrition Faculty of Home Economics, Kyushu Women's University, Kitakyushu, Japan.
Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Japan.
Gerodontology. 2021 Mar;38(1):104-112. doi: 10.1111/ger.12506. Epub 2020 Nov 10.
To analyse malpractice litigation cases in Japan and identify the factors related to choking accidents in older people.
Choking while eating is common in older people and has potentially severe consequences.
This study analysed court decisions related to choking accidents occurring in Japan between 2000 and 2015 that involved the death of an older person or permanent severe choking-related injury. A database of court decisions (n = 23) was constructed according to patient and caregiver characteristics, and nursing services. An analysis was performed on caregiver liability, and to identify factors related to choking accidents.
The court ruled that the caregiver was liable in 10 of the 23 cases. Liability was related to appropriate food choices, failure to monitor of eating or the non-performance of resuscitation after an accident. Prior knowledge of aspiration (P < .001), inappropriate assistance during the meal (P < .001), and inappropriate emergency treatment (P = .028) were more likely to be present in cases in which caregivers were judged liable than in those in which they were not.
Lack of appropriate assistance during the meal was the factor most strongly associated with a court ruling of caregiver liability for choking accidents in older people.
分析日本的医疗事故诉讼案例，确定与老年人噎食事故相关的因素。
老年人噎食较为常见，且可能产生严重后果。
本研究分析了 2000 年至 2015 年间在日本发生的与噎食相关的老年人死亡或永久性严重伤害的事故案例的法庭判决，这些案例涉及到老年人。根据患者和护理人员的特点以及护理服务，建立了一个包含 23 例案例的法庭判决数据库。对护理人员的责任进行了分析，并确定了与噎食事故相关的因素。
在 23 例案例中，有 10 例法庭裁定护理人员负有责任。责任与适当的食物选择、未能对进食进行监控或事故发生后未进行复苏有关。有过吸入史（P<0.001）、用餐时提供不当帮助（P<0.001）和不适当的急救处理（P=0.028）的情况下，护理人员被判定负有责任的可能性更高。
用餐时缺乏适当的帮助是与老年人噎食事故中护理人员责任判定最相关的因素。
