Adil H Ahmed1, Charat Thongprayoon2, Louis A Schenck3, Michael Malinchoc4, Andrea Konvalinová5, Mark T Keegan6, Ognjen Gajic7, Brian W Pickering6. 1. Multidisciplinary Epidemiology and Translational Research in Intensive Care, Mayo Clinic, Rochester, MN; North Central Texas Medical Foundation, Wichita Falls Family Practice Residency Program, Wichita Falls, TX. 2. Multidisciplinary Epidemiology and Translational Research in Intensive Care, Mayo Clinic, Rochester, MN; Department of Anesthesiology, Mayo Clinic, Rochester, MN. Electronic address: thongprayoon.charat@mayo.edu. 3. Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN. 4. Multidisciplinary Epidemiology and Translational Research in Intensive Care, Mayo Clinic, Rochester, MN; Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN. 5. Multidisciplinary Epidemiology and Translational Research in Intensive Care, Mayo Clinic, Rochester, MN. 6. Multidisciplinary Epidemiology and Translational Research in Intensive Care, Mayo Clinic, Rochester, MN; Department of Anesthesiology, Mayo Clinic, Rochester, MN. 7. Multidisciplinary Epidemiology and Translational Research in Intensive Care, Mayo Clinic, Rochester, MN; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.
Abstract
OBJECTIVE: To explore the effect of various adverse hospital events on short- and long-term outcomes in a cohort of acutely ill hospitalized patients. PATIENTS AND METHODS: In a secondary analysis of a retrospective cohort of acutely ill hospitalized patients with sepsis, shock, or pneumonia or undergoing high-risk surgery who were at risk for or had developed acute respiratory distress syndrome between 2001 and 2010, the effects of potentially preventable hospital exposures and adverse events (AEs) on in-hospital and intensive care unit (ICU) mortality, length of stay, and long-term survival were analyzed. Adverse effects chosen for inclusion were inadequate empiric antimicrobial coverage, hospital-acquired aspiration, medical or surgical misadventure, inappropriate blood product transfusion, and injurious tidal volume while on mechanical ventilation. RESULTS: In 828 patients analyzed, the distribution of 0, 1, 2, and 3 or more cumulative AEs was 521 (63%), 126 (15%), 135 (16%), and 46 (6%) patients, respectively. The adjusted odds ratios (95% CI) for in-hospital mortality in patients who had 1, 2, and 3 or more AEs were 0.9 (0.5-1.7), 0.9 (0.5-1.6), and 1.4 (0.6-3.3), respectively. One AE increased the length of stay, difference between means (95% CI), in the hospital by 8.7 (3.8-13.7) days and in the ICU by 2.4 (0.6-4.2) days. CONCLUSION: Potentially preventable hospital exposure to AEs is associated with prolonged ICU and hospital lengths of stay. Implementation of effective patient safety interventions is of utmost priority in acute care hospitals.
OBJECTIVE: To explore the effect of various adverse hospital events on short- and long-term outcomes in a cohort of acutely ill hospitalized patients. PATIENTS AND METHODS: In a secondary analysis of a retrospective cohort of acutely ill hospitalized patients with sepsis, shock, or pneumonia or undergoing high-risk surgery who were at risk for or had developed acute respiratory distress syndrome between 2001 and 2010, the effects of potentially preventable hospital exposures and adverse events (AEs) on in-hospital and intensive care unit (ICU) mortality, length of stay, and long-term survival were analyzed. Adverse effects chosen for inclusion were inadequate empiric antimicrobial coverage, hospital-acquired aspiration, medical or surgical misadventure, inappropriate blood product transfusion, and injurious tidal volume while on mechanical ventilation. RESULTS: In 828 patients analyzed, the distribution of 0, 1, 2, and 3 or more cumulative AEs was 521 (63%), 126 (15%), 135 (16%), and 46 (6%) patients, respectively. The adjusted odds ratios (95% CI) for in-hospital mortality in patients who had 1, 2, and 3 or more AEs were 0.9 (0.5-1.7), 0.9 (0.5-1.6), and 1.4 (0.6-3.3), respectively. One AE increased the length of stay, difference between means (95% CI), in the hospital by 8.7 (3.8-13.7) days and in the ICU by 2.4 (0.6-4.2) days. CONCLUSION: Potentially preventable hospital exposure to AEs is associated with prolonged ICU and hospital lengths of stay. Implementation of effective patient safety interventions is of utmost priority in acute care hospitals.
Authors: Frank Dodoo-Schittko; Susanne Brandstetter; Magdalena Brandl; Sebastian Blecha; Michael Quintel; Steffen Weber-Carstens; Stefan Kluge; Patrick Meybohm; Caroline Rolfes; Björn Ellger; Friedhelm Bach; Tobias Welte; Thomas Muders; Kathrin Thomann-Hackner; Thomas Bein; Christian Apfelbacher Journal: J Thorac Dis Date: 2017-03 Impact factor: 2.895
Authors: Matthew J Reed; Megan McGrath; Polly L Black; Steff Lewis; Christopher McCann; Stewart Whiting; Rachel O'Brien; Alison Grant; Beth Harrison; Laura Skyrme; Miranda Odam Journal: Diagn Progn Res Date: 2018-09-03
Authors: Ana María Porcel-Gálvez; Sergio Barrientos-Trigo; Eugenia Gil-García; Olivia Aguilera-Castillo; Antonio Juan Pérez-Fernández; Elena Fernández-García Journal: Int J Environ Res Public Health Date: 2020-10-29 Impact factor: 3.390