Adverse events leading to intensive care unit admission in a low-and-middle-income-country: A prospective cohort study and a systematic review

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article
Data de publicação
2024
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W B SAUNDERS CO-ELSEVIER INC
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JOURNAL OF CRITICAL CARE, v.80, article ID 154510, 6p, 2024
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Introduction: Adverse events (AE) are frequent in critical care and could be even more prevalent in LMIC due to a shortage of ICU beds and Human resources. There is limited data on how relevant AE are among the reasons for ICU admission, being all of which published by High-Income-Countries services. Our main goal is to describe the rate of adverse events-related ICU admissions and their preventability in a LMIC scenario, comparing our results with previous data.Methods: This was a prospective cohort study, during a one-year period, in two general ICUs from a tertiary public academic hospital. Our exposure of interest was ICU admission related to an AE in adult patients, we further characterized their preventability and clinical outcomes. We also performed a systematic review to identify and compare previous published data on ICU admissions due to AE.Results: Among all ICU admissions, 12.1% were related to an AE (9.8% caused by an AE, 2.3% related but not directly caused by an AE). These ICU admissions were not associated with a higher risk of death, but most of them were potentially preventable (70.9% of preventability rate, representing 8.6% of all ICU admissions). The meta-analysis resulted in a proportion of ICU admissions due to AE of 11% (95% CI 6%-16%), with a pre-ventability rate of 54% (95% CI 42%-66%).Conclusions: In this prospective cohort, adverse events were a relevant reason for ICU admission. This result is consistent with data retrieved from non-LMIC as shown in our meta-analysis. The high preventability rate described reinforces that quality and safety programs could work as a tool to optimize scarce resources.
Palavras-chave
Critical illness, Developing countries, Risk management
Referências
  1. Adamuz J, 2020, PLOS ONE, V15, DOI 10.1371/journal.pone.0236370
  2. Adhikari NKJ, 2013, BMJ QUAL SAF, V22, P798, DOI 10.1136/bmjqs-2013-002396
  3. Arya S, 2021, JAMA SURG, V156, P789, DOI 10.1001/jamasurg.2021.0546
  4. Cecconi M, 2024, INTENS CARE MED, V50, P136, DOI 10.1007/s00134-023-07268-5
  5. Chen WS, 2018, BMC MED RES METHODOL, V18, DOI 10.1186/s12874-018-0519-5
  6. Cuschieri S, 2019, SAUDI J ANAESTH, V13, P31, DOI 10.4103/sja.SJA_543_18
  7. Darchy B, 1999, ARCH INTERN MED, V159, P71, DOI 10.1001/archinte.159.1.71
  8. de Oliveira AC, 2016, REV ESC ENFERM USP, V50, P679, DOI 10.1590/S0080-623420160000500020
  9. Devlin JW, 2010, CRIT CARE MED, V38, pS231, DOI 10.1097/CCM.0b013e3181de125a
  10. DONCHIN Y, 1995, CRIT CARE MED, V23, P294, DOI 10.1097/00003246-199502000-00015
  11. Garry DA, 2014, ANAESTHESIA, V69, P137, DOI 10.1111/anae.12535
  12. Hoogervorst-Schilp J, 2015, BMC HEALTH SERV RES, V15, DOI 10.1186/s12913-015-1205-5
  13. Jha AK, 2013, BMJ QUAL SAF, V22, P809, DOI 10.1136/bmjqs-2012-001748
  14. Karna K, 2012, Study And Evaluation Of Medication Errors In A Tertiary Care Teaching Hospital-A Baseline Study
  15. Kjellberg J, 2017, BMC HEALTH SERV RES, V17, DOI 10.1186/s12913-017-2605-5
  16. Kruk ME, 2018, LANCET, V392, P2203, DOI [10.1016/S0140-6736(18)31668-4, 10.1016/s0140-6736(18)31668-4]
  17. Lancis-Sepúlveda ML, 2014, REV CALID ASSIST, V29, P78, DOI 10.1016/j.cali.2013.10.003
  18. Lehmann LS, 2005, AM J MED, V118, P409, DOI 10.1016/j.amjmed.2005.01.012
  19. Machado FR, 2016, NEW ENGL J MED, V375, P2420, DOI 10.1056/NEJMp1610059
  20. Makary MA, 2016, BMJ-BRIT MED J, V353, DOI 10.1136/bmj.i2139
  21. McElroy LM, 2016, INT J QUAL HEALTH C, V28, P166, DOI 10.1093/intqhc/mzw001
  22. McHugh MD, 2021, LANCET, V397, P1905, DOI 10.1016/S0140-6736(21)00768-6
  23. Mendonça VS, 2016, HEALTH PSYCHOL RES, V4, P38, DOI 10.4081/hpr.2016.5408
  24. Mercier E, 2010, INTENS CARE MED, V36, P1033, DOI 10.1007/s00134-010-1793-9
  25. Montroy J, 2016, PLOS ONE, V11, DOI 10.1371/journal.pone.0146254
  26. Nauman J, 2020, CUREUS J MED SCIENCE, V12, DOI 10.7759/cureus.7265
  27. Odukoya O, 2021, HEALTH TECHNOL-GER, V11, P1297, DOI 10.1007/s12553-021-00600-3
  28. Poidevin A, 2014, ANN FR ANESTH, V33, P503, DOI 10.1016/j.annfar.2014.06.005
  29. Salvini R, 2021, SWISS MED WKLY, V151, DOI 10.4414/smw.2021.20414
  30. Sherman H, 2009, INT J QUAL HEALTH C, V21, P2, DOI 10.1093/intqhc/mzn054
  31. STAMBOULY JJ, 1990, CRIT CARE MED, V18, P1248, DOI 10.1097/00003246-199011000-00013
  32. Strand K, 2008, ACTA ANAESTH SCAND, V52, P467, DOI 10.1111/j.1399-6576.2008.01586.x
  33. TRUNET P, 1980, JAMA-J AM MED ASSOC, V244, P2617, DOI 10.1001/jama.244.23.2617
  34. Vikan M, 2023, BMC HEALTH SERV RES, V23, DOI 10.1186/s12913-023-09332-8
  35. Vlayen A, 2012, J EVAL CLIN PRACT, V18, P485, DOI 10.1111/j.1365-2753.2010.01612.x
  36. Zampieri Fernando Godinho, 2017, Rev. bras. ter. intensiva, V29, P418, DOI [10.5935/0103-507X.20170062, 10.5935/0103-507x.20170062]