Herbst C A
Arch Surg. 1978 Dec;113(12):1421-5. doi: 10.1001/archsurg.1978.01370240043006.
A retrospective outcome-oriented audit was conducted to determine the complications associated with percutaneous infraclavicular subclavian catheters in a university hospital. The study is unique since patients having these catheters were not under the care of a select group of physicians and the patients were not restricted to a special nursing unit. One hundred and seventeen catheters were placed in 68 patients. Seventeen types of complications were audited. There were 13 complications (11%) identified as follows: pneumothorax, seven; subcutaneous emphysema, one; subclavian artery hematoma, one; pleural effusion, one; improper position, two; and sepsis, one. No mortality was associated with catheter placement. Pattern analysis suggested physician inexperience as an important cause of complications. The difficulties of establishing a retrospective audit based on documentation errors and omissions are discussed.
为了确定大学医院中经皮锁骨下锁骨下导管相关的并发症，开展了一项以结果为导向的回顾性审计。该研究具有独特性，因为留置这些导管的患者并非由特定的医生团队护理，且患者也不限于特殊护理单元。在68名患者中放置了117根导管。对17种并发症进行了审计。共发现13例并发症（11%），具体如下：气胸，7例；皮下气肿，1例；锁骨下动脉血肿，1例；胸腔积液，1例；位置不当，2例；败血症，1例。导管放置未导致死亡。模式分析表明医生经验不足是并发症的一个重要原因。还讨论了基于文件错误和遗漏进行回顾性审计的困难。
