Surgery Is in Itself a Risk Factor for the Patient

Ostáriz, Verónica Aranaz; Castro, M.T. Gea-Velázquez de; López-Rodríguez-Arias, Francisco; Jose-Saras, Diego San; Vicente-Guijarro, Jorge; Pardo-Hernández, Alberto; Aranaz-Andrés, Jesús María

doi:10.3390/ijerph19084761

Cited by 6 publications

(2 citation statements)

References 39 publications

(40 reference statements)

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“…The ESHMAD study wanted to estimate the prevalence of AEs in 34 public hospitals in the Community of Madrid [ 21 , 22 ]. ESHMAD database was used also in another work, which focused on how surgical interventions could increase the risk of developing an AE in the surgical patients of the whole sample [ 28 ].…”

Section: Methodsmentioning

confidence: 99%

Adverse events: an expensive and avoidable hospital problem

et al. 2022

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Introduction Adverse healthcare-related events (AE) entail reduced patient safety. Estimating their frequency, characteristics, avoidability and impact is a means to identify targets for improvement in the quality of care. Methods This was a descriptive observational study conducted within the Patient Safety Incident Study in Hospitals in the Community of Madrid (ESHMAD). The study was conducted in a high-complexity hospital in May 2019 through a two-phase electronic medical record review: (1) AE screening and epidemiological and clinical data collection and (2) AE review and classification and analysis of their impact, avoidability, and associated costs. Results A total of 636 patients were studied. The prevalence of AE was 12.4%. Death during the stay was associated with the presence of AE (OR [CI95%]: 2.15 [1.07 to 4.52]) versus absence and emergency admission (OR [CI95%]: 17.11[6.63 to 46.26]) versus scheduled. A total of 70.2% of the AEs were avoidable. Avoidable AEs were associated with the presence of pressure ulcers (OR [CI95%]: 2.77 [1.39 to 5.51]), central venous catheter (OR [CI95%]: 2.58 [1.33 to 5.00]) and impaired mobility (OR [CI95%]: 2.24[1.35 to 3.71]), versus absences. They were associated too with the stays in the intensive care unit (OR [CI95%]: 2.75 [1.07 to 7.06]) versus medical service. AEs were responsible for additional costs of €909,716.8 for extra days of stay and €12,461.9 per patient with AE. Conclusions The prevalence of AEs was similar to that found in other studies. AEs led to worse patient outcomes and were associated with the patient’s death. Although avoidable AEs were less severe, their higher frequency produced a greater impact on the patient and healthcare system. Key messages Adverse events are one of the main problems in healthcare delivery and patients who suffer from at least one AE are double as likely to die during hospitalization. Avoidable adverse events are the most frequent in health care and they are a good target where achieve improvement areas that allow getting optimal patient safety and quality of care levels. Patients hospitalized in the ICU, with the previous presence of pressure ulcers, central venous catheter, or impaired mobility were associated with the development of avoidable AE, so optimal management of these patients would reduce the impact of AE.

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Section: Methodsmentioning

confidence: 99%

Adverse events: an expensive and avoidable hospital problem

et al. 2022

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“…Surgery is an essential component of health care, and due to advances in technology, pathologies that were previously unamenable to surgical treatment are now routinely operated on [ 4 ] . This could explain why over half of all adverse events in a hospital (51%–62%) occur during surgical care 6 , 12 , 37 , why surgical procedures cause complications in approximately 25% of patients, or why one million patients die annually during or immediately following surgery (WHO guidelines for safe surgery, 2009).…”

Section: Introductionmentioning

confidence: 99%