Valencia-Martín J L, Vicente-Guijarro J, San Jose-Saras D, Moreno-Nunez P, Pardo-Hernández A, Aranaz-Andrés J M
Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain. Facultad de Ciencias de la Salud, Universidad Internacional de La Rioja, Logroño, La Rioja, Spain.
Eur J Clin Invest. 2022 Jul 31;52(12):e13851. doi: 10.1111/eci.13851.
Adverse Events (AE) are one of the main problems in healthcare. Therefore, many policies have been developed worldwide to mitigate their impact. The Patient Safety Incident Study in Hospitals in the Community of Madrid (ESHMAD) measures the results of them in the region.
Cross-sectional study, conducted in May 2019, in hospitalised patients in 34 public hospitals using the Harvard Medical Practice Study methodology. A logistic regression model was carried out to study the association of the variables with the presence of AE, calibrated and adjusted by patient.
A total of 9,975 patients were included, estimating a prevalence of AE of 11.9%. A higher risk of AE was observed in patients with surgical procedures (OR[CI95%]: 2.15[1.79 to 2.57], vs. absence), in Intensive Care Units (OR[CI95%]: 1.60[1.17 to 2.17], vs. Medical), and in hospitals of medium complexity (OR[CI95%]: 1.45[1.12 to 1.87], vs. low complexity). A 62.6% of AE increased the length of the stay or it was the cause of admission, and 46.9% of AE were considered preventable. In 11.5% of patients with AE, they had contributed to their death.
The prevalence of AE remains similar to the previously estimated in studies developed with the same methodology. AE keep leading to longer hospital stays, contributing to patient's death, showing that it is necessary to put focus on patient safety again. A detailed analysis of these events has enabled the detection of specific areas for improvement according to the type of care, centre, and patient.
不良事件（AE）是医疗保健中的主要问题之一。因此，全球已制定了许多政策来减轻其影响。马德里社区医院患者安全事件研究（ESHMAD）衡量了该地区这些政策的效果。
2019年5月进行的横断面研究，采用哈佛医疗实践研究方法，对34家公立医院的住院患者进行研究。进行逻辑回归模型以研究变量与不良事件发生之间的关联，并按患者进行校准和调整。
共纳入9975例患者，估计不良事件患病率为11.9%。手术患者（比值比[95%置信区间]：2.15[1.79至2.57]，与无手术相比）、重症监护病房患者（比值比[95%置信区间]：1.60[1.17至2.17]，与内科相比）以及中等复杂程度医院的患者（比值比[95%置信区间]：1.45[1.12至1.87]，与低复杂程度医院相比）发生不良事件的风险更高。62.6%的不良事件增加了住院时间或导致入院，46.9%的不良事件被认为是可预防的。在11.5%发生不良事件的患者中，不良事件导致了他们的死亡。
不良事件的患病率与之前采用相同方法进行的研究所估计的患病率相似。不良事件继续导致住院时间延长，致使患者死亡，这表明有必要再次关注患者安全。对这些事件的详细分析有助于根据护理类型、中心和患者情况确定具体的改进领域。
