array:20 [ "pii" => "13113630" "issn" => "1134282X" "doi" => "10.1016/S1134-282X(07)71236-8" "estado" => "S300" "fechaPublicacion" => "2007-11-01" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Rev Calidad Asistencial. 2007;22:277-86" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3467 "formatos" => array:3 [ "EPUB" => 48 "HTML" => 2436 "PDF" => 983 ] ] "itemSiguiente" => array:16 [ "pii" => "13113639" "issn" => "1134282X" "doi" => "10.1016/S1134-282X(07)71237-X" "estado" => "S300" "fechaPublicacion" => "2007-11-01" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Rev Calidad Asistencial. 2007;22:287-98" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3529 "formatos" => array:3 [ "EPUB" => 47 "HTML" => 2702 "PDF" => 780 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Mejora de la seguridad y evaluación de los resultados del proceso de anticoagulación oral implantado en un área de atención primaria" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "287" "paginaFinal" => "298" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Safety improvement and evaluation of the results of the process of oral anticoagulation therapy implanted in a primary care area" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Asunción Cañada Dorado, José M Mena Mateo, Luis Sánchez Perruca, David Rodríguez Morales, Juan Cárdenas Valladolid" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Asunción" "apellidos" => "Cañada Dorado" ] 1 => array:2 [ "nombre" => "José M" "apellidos" => "Mena Mateo" ] 2 => array:2 [ "nombre" => "Luis" "apellidos" => "Sánchez Perruca" ] 3 => array:2 [ "nombre" => "David" "apellidos" => "Rodríguez Morales" ] 4 => array:2 [ "nombre" => "Juan" "apellidos" => "Cárdenas Valladolid" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/13113639?idApp=UINPBA00004N" "url" => "/1134282X/0000002200000006/v0_201308011132/13113639/v0_201308011132/es/main.assets" ] "itemAnterior" => array:16 [ "pii" => "13113636" "issn" => "1134282X" "doi" => "10.1016/S1134-282X(07)71235-6" "estado" => "S300" "fechaPublicacion" => "2007-11-01" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Rev Calidad Asistencial. 2007;22:272-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3764 "formatos" => array:3 [ "EPUB" => 63 "HTML" => 3093 "PDF" => 608 ] ] "es" => array:11 [ "idiomaDefecto" => true "titulo" => "Iatrogenia atribuible a las pruebas diagnósticas" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "272" "paginaFinal" => "276" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Iatrogeny attributable to diagnostic tests" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Blanca Lumbreras, Ildefonso Hernández-Aguado" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Blanca" "apellidos" => "Lumbreras" ] 1 => array:2 [ "nombre" => "Ildefonso" "apellidos" => "Hernández-Aguado" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/13113636?idApp=UINPBA00004N" "url" => "/1134282X/0000002200000006/v0_201308011132/13113636/v0_201308011132/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "titulo" => "Incidencia de efectos adversos en una unidad de medicina intensiva" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "277" "paginaFinal" => "286" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Isabel Gutiérrez Cía, Carlos Aibar Remón, Asunción Beamonte San Agustín, Blanca Obón Azuara, Carlos Sánchez Polo, Diego Júdez Legaristi" "autores" => array:6 [ 0 => array:3 [ "nombre" => "Isabel" "apellidos" => "Gutiérrez Cía" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 1 => array:3 [ "nombre" => "Carlos" "apellidos" => "Aibar Remón" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] ] ] 2 => array:3 [ "nombre" => "Asunción" "apellidos" => "Beamonte San Agustín" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "affc" ] ] ] 3 => array:3 [ "nombre" => "Blanca" "apellidos" => "Obón Azuara" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 4 => array:3 [ "nombre" => "Carlos" "apellidos" => "Sánchez Polo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "affd" ] ] ] 5 => array:3 [ "nombre" => "Diego" "apellidos" => "Júdez Legaristi" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Intensiva. Hospital Clínico Universitario Lozano Blesa. Zaragoza. España." "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] 1 => array:3 [ "entidad" => "Servicio de Medicina Preventiva y Salud Pública. Hospital Clínico Universitario Lozano Blesa. Zaragoza. España." "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] 2 => array:3 [ "entidad" => "Escuela Universitaria de Estudios Empresariales. Zaragoza. España." "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "affc" ] 3 => array:3 [ "entidad" => "Unidad de Medicina Intensiva. Hospital Obispo Polanco. Teruel. España." "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "affd" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Incidence of adverse events in an intensive care unit" ] ] "pdfFichero" => "256v22n06a13113630pdf001.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec233235" "palabras" => array:3 [ 0 => "Efectos adversos" 1 => "Seguridad" 2 => "Evaluación del riesgo" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec233236" "palabras" => array:3 [ 0 => "Adverse events" 1 => "Safety" 2 => "Risk assessment" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "Objetivos: Los pacientes críticos tienen un riesgo especialmente alto de presentar efectos adversos (EA). En este trabajo estudiamos la incidencia de EA en una unidad de cuidados intensivos (UCI) para identificar los factores que incrementan el riesgo de presentarlos, los clasificamos según su gravedad y medimos su influencia en la estancia en UCI. Material y método: Estudio prospectivo de cohortes realizado en los pacientes ingresados en una UCI de un hospital pequeño en 1 año. La revisión se llevó a cabo en dos fases: primero se utilizó una guía de cribado y en segundo lugar se revisaron las historias seleccionadas mediante un cuestionario de confirmación para identificar los EA. Se analizó la influencia de la edad, el sexo, el diagnóstico, la puntuación APACHE y la estancia en la aparición de EA. Se determinó la repercusión de los EA en la estancia del paciente en la unidad. Se clasificaron los EA en tres grupos: graves, moderados y leves. Resultados: Se revisaron 416 historias clínicas y la guía de cribado seleccionó 259. El 29% de los pacientes (121) presentaron 172 EA. La edad y el sexo no demostraron influencia. Los pacientes con estancias prolongadas presentaron EA con mayor frecu encia (49%) que los que tuvieron estancias cortas (24%). La puntuación APACHE fue más elevada en los pacientes que presentaron EA. El grupo diagnóstico que con mayor frecuencia presentó EA fue el de pacientes sépticos. Ocurrieron un 59,3% de EA graves, un 14% de EA moderados y un 26,7% de EA leves. Los EA motivaron 323 estancias, es decir, el 22,5% del total de las estancias en UCI. Conclusiones: Los EA son frecuentes entre los pacientes críticos. La mayor gravedad y la estancia prolongada incrementaron el riesgo de EA. Los EA fueron graves y prolongaron la estancia de los pacientes en la UCI." ] "en" => array:1 [ "resumen" => "Objectives: Critically ill patients have an especially high risk of adverse events (AE). We sought to study the incidence of AE in an intensive care unit (ICU) to identify which factors could increase the risk of AE, determine their severity, and evaluate their influence on length of stay. Material and method: We performed a prospective 1-year cohort study in patients admitted to the ICU of a small hospital. The study was carried out in two phases: in the first phase, a screening guide was used and in the second phase, positively screened records were reviewed to identify AEs. The influence of age, sex, diagnosis, APACHE score and length of stay on the occurrence of AE were analyzed and the effect of these events on the patient's length of stay in the unit was determined. AE were classified in three groups: serious, moderate and minor. Results: We reviewed 416 records and screened 259. One hundred twenty-one (29%) patients had 172 AE. Age and sex had no influence. AE were more frequent in patients with longer stays (49%) than in those with shorter stays (24%). The APACHE score was higher in patients with AE. The most frequent diagnosis in the AE group was sepsis. A total of 59.3% AE were serious, 14% were moderate and 26.7% were minor. AE prolonged ICU stay by 323 patient-days, representing 22.5% of ICU time. Conclusions: AE were frequent in critically ill patients. Greater severity and prolonged stay increased the risk of AE. AE were serious and prolonged ICU stay." ] ] "multimedia" => array:9 [ 0 => array:6 [ "identificador" => "tbl1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tablaImagen" => array:1 [ 0 => array:4 [ "imagenFichero" => "256v22n06-13113630tab01.gif" "imagenAlto" => 1147 "imagenAncho" => 566 "imagenTamanyo" => 63548 ] ] ] ] ] ] 1 => array:6 [ "identificador" => "tbl2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tablaImagen" => array:1 [ 0 => array:4 [ "imagenFichero" => "256v22n06-13113630tab02.gif" "imagenAlto" => 650 "imagenAncho" => 570 "imagenTamanyo" => 19289 ] ] ] ] ] ] 2 => array:8 [ "identificador" => "tbl3" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tablaImagen" => array:1 [ 0 => array:4 [ "imagenFichero" => "256v22n06-13113630tab03.gif" "imagenAlto" => 284 "imagenAncho" => 547 "imagenTamanyo" => 6389 ] ] ] ] ] "descripcion" => array:1 [ "es" => "Flujograma de revisión de historias." ] ] 3 => array:6 [ "identificador" => "tbl4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tablaImagen" => array:1 [ 0 => array:4 [ "imagenFichero" => "256v22n06-13113630tab04.gif" "imagenAlto" => 315 "imagenAncho" => 567 "imagenTamanyo" => 10713 ] ] ] ] ] ] 4 => array:8 [ "identificador" => "tbl5" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tablaImagen" => array:1 [ 0 => array:4 [ "imagenFichero" => "256v22n06-13113630tab05.gif" "imagenAlto" => 267 "imagenAncho" => 514 "imagenTamanyo" => 10791 ] ] ] ] ] "descripcion" => array:1 [ "es" => "Efectos adversos en pacientes con estancia de hasta 4 días o de más de 4 días." ] ] 5 => array:6 [ "identificador" => "tbl6" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tablaImagen" => array:1 [ 0 => array:4 [ "imagenFichero" => "256v22n06-13113630tab06.gif" "imagenAlto" => 273 "imagenAncho" => 567 "imagenTamanyo" => 8082 ] ] ] ] ] ] 6 => array:6 [ "identificador" => "tbl7" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tablaImagen" => array:1 [ 0 => array:4 [ "imagenFichero" => "256v22n06-13113630tab07.gif" "imagenAlto" => 413 "imagenAncho" => 563 "imagenTamanyo" => 10850 ] ] ] ] ] ] 7 => array:6 [ "identificador" => "tbl8" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tablaImagen" => array:1 [ 0 => array:4 [ "imagenFichero" => "256v22n06-13113630tab08.gif" "imagenAlto" => 405 "imagenAncho" => 575 "imagenTamanyo" => 10665 ] ] ] ] ] ] 8 => array:6 [ "identificador" => "tbl9" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tablaImagen" => array:1 [ 0 => array:4 [ "imagenFichero" => "256v22n06-13113630tab09.gif" "imagenAlto" => 445 "imagenAncho" => 562 "imagenTamanyo" => 11660 ] ] ] ] ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:74 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Origen de la Medicina Intensiva en España: historia de una revolución." "idioma" => "es" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Gomez Rubí J." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Intensiva" "fecha" => "1998" "volumen" => "22" "paginaInicial" => "421" "paginaFinal" => "8" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Infection and error called special hazards of intensive care units." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Mod Hosp" "fecha" => "1966" "volumen" => "107" "paginaInicial" => "98" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/5978521" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Building safety into ICU." 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Información de la revista
Vol. 22. Núm. 6.
Páginas 277-286 (noviembre 2007)
Vol. 22. Núm. 6.
Páginas 277-286 (noviembre 2007)
Acceso a texto completo
Incidencia de efectos adversos en una unidad de medicina intensiva
Incidence of adverse events in an intensive care unit
Visitas
5004
Isabel Gutiérrez Cíaa, Carlos Aibar Remónb, Asunción Beamonte San Agustínc, Blanca Obón Azuaraa, Carlos Sánchez Polod, Diego Júdez Legaristib
a Servicio de Medicina Intensiva. Hospital Clínico Universitario Lozano Blesa. Zaragoza. España.
b Servicio de Medicina Preventiva y Salud Pública. Hospital Clínico Universitario Lozano Blesa. Zaragoza. España.
c Escuela Universitaria de Estudios Empresariales. Zaragoza. España.
d Unidad de Medicina Intensiva. Hospital Obispo Polanco. Teruel. España.
Este artículo ha recibido
Información del artículo
Objetivos: Los pacientes críticos tienen un riesgo especialmente alto de presentar efectos adversos (EA). En este trabajo estudiamos la incidencia de EA en una unidad de cuidados intensivos (UCI) para identificar los factores que incrementan el riesgo de presentarlos, los clasificamos según su gravedad y medimos su influencia en la estancia en UCI. Material y método: Estudio prospectivo de cohortes realizado en los pacientes ingresados en una UCI de un hospital pequeño en 1 año. La revisión se llevó a cabo en dos fases: primero se utilizó una guía de cribado y en segundo lugar se revisaron las historias seleccionadas mediante un cuestionario de confirmación para identificar los EA. Se analizó la influencia de la edad, el sexo, el diagnóstico, la puntuación APACHE y la estancia en la aparición de EA. Se determinó la repercusión de los EA en la estancia del paciente en la unidad. Se clasificaron los EA en tres grupos: graves, moderados y leves. Resultados: Se revisaron 416 historias clínicas y la guía de cribado seleccionó 259. El 29% de los pacientes (121) presentaron 172 EA. La edad y el sexo no demostraron influencia. Los pacientes con estancias prolongadas presentaron EA con mayor frecu encia (49%) que los que tuvieron estancias cortas (24%). La puntuación APACHE fue más elevada en los pacientes que presentaron EA. El grupo diagnóstico que con mayor frecuencia presentó EA fue el de pacientes sépticos. Ocurrieron un 59,3% de EA graves, un 14% de EA moderados y un 26,7% de EA leves. Los EA motivaron 323 estancias, es decir, el 22,5% del total de las estancias en UCI. Conclusiones: Los EA son frecuentes entre los pacientes críticos. La mayor gravedad y la estancia prolongada incrementaron el riesgo de EA. Los EA fueron graves y prolongaron la estancia de los pacientes en la UCI.
Palabras clave:
Efectos adversos
Seguridad
Evaluación del riesgo
Objectives: Critically ill patients have an especially high risk of adverse events (AE). We sought to study the incidence of AE in an intensive care unit (ICU) to identify which factors could increase the risk of AE, determine their severity, and evaluate their influence on length of stay. Material and method: We performed a prospective 1-year cohort study in patients admitted to the ICU of a small hospital. The study was carried out in two phases: in the first phase, a screening guide was used and in the second phase, positively screened records were reviewed to identify AEs. The influence of age, sex, diagnosis, APACHE score and length of stay on the occurrence of AE were analyzed and the effect of these events on the patient's length of stay in the unit was determined. AE were classified in three groups: serious, moderate and minor. Results: We reviewed 416 records and screened 259. One hundred twenty-one (29%) patients had 172 AE. Age and sex had no influence. AE were more frequent in patients with longer stays (49%) than in those with shorter stays (24%). The APACHE score was higher in patients with AE. The most frequent diagnosis in the AE group was sepsis. A total of 59.3% AE were serious, 14% were moderate and 26.7% were minor. AE prolonged ICU stay by 323 patient-days, representing 22.5% of ICU time. Conclusions: AE were frequent in critically ill patients. Greater severity and prolonged stay increased the risk of AE. AE were serious and prolonged ICU stay.
Keywords:
Adverse events
Safety
Risk assessment
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