Ali Waleed Ibraheem, Hakeem Layla Ali, Mohammed Zainab Taha, Fawzi Hayder Adnan
Department of Medicine, College of Medicine, University of Baghdad, Baghdad, Iraq.
Critical Care Unit, Ghazi Al-Hariri Teaching Hospital, Medical City Teaching Complex, Baghdad, Iraq.
Medicine (Baltimore). 2025 Sep 12;104(37):e44412. doi: 10.1097/MD.0000000000044412.
This study aims to estimate the rate of incidental errors (InE) in the intensive care unit (ICU) and assess the impact of these errors on patient mortality. A prospective cohort study was conducted in the ICU of a tertiary hospital. The study included InE that occurred during patients' admission to the ICU. A total of 1026 cases were admitted to the ICU; InE happened in 142 cases (13.84%). The total number of deaths was 306 cases (29.8% of total admissions), with 40 cases (28.2%) dying in the InE group. In the InE group, there is no difference in age, sex, and cause of admission regarding mortality. The reason for admission of those cases with adverse events was variable; the most common cause of admission was medical conditions requiring ICU, followed by traumatic brain injury and postoperative observation. Regarding the intervention required, the use of a bronchoscope and paracentesis was significantly associated with increased mortality, while receiving plasma pheresis was significantly associated with lower mortality. The mean APACHE II score was higher in cases that resulted in death (40.80 ± 4.72 vs 31.67 ± 8.97), with a range of 15% to 50%. Regarding incidental adverse events, bedsores were the most common adverse event in cases that resulted in death, followed by endotracheal tube blockage, tracheostomy blockage, and pneumothorax. At the same time, only blocked tubes and bed sores were significantly higher in the cases that died. The reported InE in this study were not associated with increased mortality. Mortality was more frequent in cases of blocked endotracheal tubes and cases that developed bed sores.
本研究旨在估算重症监护病房（ICU）中偶然误差（InE）的发生率，并评估这些误差对患者死亡率的影响。在一家三级医院的ICU进行了一项前瞻性队列研究。该研究纳入了患者入住ICU期间发生的InE。共有1026例患者入住ICU；142例（13.84%）发生了InE。死亡总数为306例（占总入院人数的29.8%），其中40例（28.2%）在InE组死亡。在InE组中，年龄、性别和入院原因在死亡率方面无差异。发生不良事件的这些病例的入院原因各不相同；最常见的入院原因是需要入住ICU的医疗状况，其次是创伤性脑损伤和术后观察。关于所需的干预措施，使用支气管镜和腹腔穿刺术与死亡率增加显著相关，而接受血浆置换术与较低的死亡率显著相关。导致死亡的病例的平均急性生理学与慢性健康状况评分系统（APACHE II）得分更高（40.80±4.72 vs 31.67±8.97），范围为15%至50%。关于偶然不良事件，压疮是导致死亡的病例中最常见的不良事件，其次是气管内导管堵塞、气管造口堵塞和气胸。同时，仅堵塞的导管和压疮在死亡病例中显著更高。本研究中报告的InE与死亡率增加无关。气管内导管堵塞和发生压疮的病例死亡率更高。
