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腹主动脉瘤干预后可避免的损伤:瑞典15年过失索赔分析

Avoidable injuries after intervention for abdominal aortic aneurysm: An analysis of negligence claims over 15 years in Sweden.

作者信息

Bergqvist David, Gustafson Pelle, Hafström Larsolof

机构信息

Department of Surgical Sciences, Section of Surgery, Academic Hospital, Uppsala University, Uppsala, Sweden.

Swedish National Patient Insurance Company, Stockholm, Sweden.

出版信息

Ups J Med Sci. 2025 Jul 22;130. doi: 10.48101/ujms.v130.12171. eCollection 2025.

Abstract

BACKGROUND

Patients, who are subjected to a patient's injury, are legally allowed a compensation for their suffering.

AIM

The negligence claims after surgical treatment of abdominal aortic aneurysms (AAA) registered in the National Swedish patient insurance company (Landstingens Ömsesidiga Försäkringsbolag [LÖF]) between 2006 and 2020 were analyzed. More than 95% of negligence claims are covered by LÖF. Special emphasis on avoidable or unavoidable injuries was made.

MATERIAL

In 15 years 17,000 abdominal aortic interventions were recorded in the Swedish vascular register (SWEDVASC), where vascular interventions in the whole country of Sweden are registered. A total of 151 negligence claims (0.9%) were reported to the insurance company. Available clinical information in the company's file of the claims was analyzed. The SWEDVASC data on AAA treatment were accessible.

RESULTS

The number of Endovascular repair (EVAR) increased significantly, but the total number of interventions decreased. There were less claims after EVAR (0.7%) compared to open surgery (1.1%). There was an increase in avoidable injuries that were economically compensated ( = 0.02). Spinal cord ischemia and intestinal ischemia were dominating causes for claims.

CONCLUSION

The increase in the number of injuries should have an impact on how to train and support colleagues under education and efforts to diminish the injuries are essential. To develop methods to diminish the risk for complications is important.

摘要

背景

遭受患者伤害的患者依法有权就其痛苦获得赔偿。

目的

分析2006年至2020年期间在瑞典国家患者保险公司(Landstingens Ömsesidiga Försäkringsbolag [LÖF])登记的腹主动脉瘤(AAA)手术治疗后的过失索赔情况。超过95%的过失索赔由LÖF承保。特别强调了可避免或不可避免的伤害。

材料

在15年里,瑞典血管登记处(SWEDVASC)记录了17000例腹主动脉干预手术,瑞典全国的血管干预手术都在此登记。共有151例过失索赔(0.9%)报告给了保险公司。分析了保险公司索赔档案中可用的临床信息。可以获取SWEDVASC关于AAA治疗的数据。

结果

血管内修复(EVAR)的数量显著增加,但干预总数减少。与开放手术(1.1%)相比,EVAR后的索赔较少(0.7%)。经济赔偿的可避免伤害有所增加(P = 0.02)。脊髓缺血和肠缺血是索赔的主要原因。

结论

伤害数量的增加应该会对如何培训和支持接受教育的同事产生影响,减少伤害的努力至关重要。开发减少并发症风险的方法很重要。

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本文引用的文献

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International Vascunet Validation of the Swedvasc Registry.国际血管网络对瑞典血管注册系统的验证。
Eur J Vasc Endovasc Surg. 2015 Dec;50(6):802-8. doi: 10.1016/j.ejvs.2015.07.021. Epub 2015 Aug 31.
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Insurance claims after vascular surgery in Sweden.瑞典血管手术后的保险索赔。
Eur J Vasc Endovasc Surg. 2011 Oct;42(4):498-505. doi: 10.1016/j.ejvs.2011.04.026. Epub 2011 Jun 12.

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