Incidencia de efectos adversos en una unidad de medicina intensiva
Incidence of adverse events in an intensive care unit
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.
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"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." 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 4 | 0 | 4 |
| 2024 Octubre | 25 | 5 | 30 |
| 2024 Septiembre | 20 | 5 | 25 |
| 2024 Agosto | 21 | 2 | 23 |
| 2024 Julio | 12 | 4 | 16 |
| 2024 Junio | 30 | 4 | 34 |
| 2024 Mayo | 23 | 6 | 29 |
| 2024 Abril | 21 | 8 | 29 |
| 2024 Marzo | 28 | 5 | 33 |
| 2024 Febrero | 20 | 3 | 23 |
| 2024 Enero | 13 | 5 | 18 |
| 2023 Diciembre | 20 | 6 | 26 |
| 2023 Noviembre | 24 | 7 | 31 |
| 2023 Octubre | 31 | 3 | 34 |
| 2023 Septiembre | 21 | 2 | 23 |
| 2023 Agosto | 12 | 3 | 15 |
| 2023 Julio | 10 | 8 | 18 |
| 2023 Junio | 18 | 3 | 21 |
| 2023 Mayo | 19 | 9 | 28 |
| 2023 Abril | 9 | 2 | 11 |
| 2023 Marzo | 10 | 11 | 21 |
| 2023 Febrero | 12 | 11 | 23 |
| 2023 Enero | 11 | 4 | 15 |
| 2022 Diciembre | 21 | 7 | 28 |
| 2022 Noviembre | 38 | 10 | 48 |
| 2022 Octubre | 22 | 12 | 34 |
| 2022 Septiembre | 36 | 8 | 44 |
| 2022 Agosto | 19 | 13 | 32 |
| 2022 Julio | 16 | 7 | 23 |
| 2022 Junio | 32 | 14 | 46 |
| 2022 Mayo | 29 | 9 | 38 |
| 2022 Abril | 23 | 25 | 48 |
| 2022 Marzo | 19 | 22 | 41 |
| 2022 Febrero | 13 | 24 | 37 |
| 2022 Enero | 9 | 11 | 20 |
| 2021 Diciembre | 12 | 12 | 24 |
| 2021 Noviembre | 28 | 7 | 35 |
| 2021 Octubre | 17 | 17 | 34 |
| 2021 Septiembre | 20 | 14 | 34 |
| 2021 Agosto | 14 | 13 | 27 |
| 2021 Julio | 8 | 7 | 15 |
| 2021 Junio | 16 | 8 | 24 |
| 2021 Mayo | 16 | 4 | 20 |
| 2021 Abril | 41 | 19 | 60 |
| 2021 Marzo | 17 | 17 | 34 |
| 2021 Febrero | 17 | 11 | 28 |
| 2021 Enero | 16 | 14 | 30 |
| 2020 Diciembre | 15 | 20 | 35 |
| 2020 Noviembre | 12 | 11 | 23 |
| 2020 Octubre | 12 | 6 | 18 |
| 2020 Septiembre | 6 | 5 | 11 |
| 2020 Agosto | 14 | 8 | 22 |
| 2020 Julio | 10 | 9 | 19 |
| 2020 Junio | 10 | 16 | 26 |
| 2020 Mayo | 14 | 9 | 23 |
| 2020 Abril | 22 | 10 | 32 |
| 2020 Marzo | 20 | 15 | 35 |
| 2020 Febrero | 15 | 8 | 23 |
| 2020 Enero | 20 | 12 | 32 |
| 2019 Diciembre | 22 | 18 | 40 |
| 2019 Noviembre | 14 | 10 | 24 |
| 2019 Octubre | 18 | 6 | 24 |
| 2019 Septiembre | 14 | 11 | 25 |
| 2019 Agosto | 16 | 5 | 21 |
| 2019 Julio | 44 | 15 | 59 |
| 2019 Junio | 54 | 44 | 98 |
| 2019 Mayo | 128 | 37 | 165 |
| 2019 Abril | 69 | 44 | 113 |
| 2019 Marzo | 17 | 9 | 26 |
| 2019 Febrero | 24 | 17 | 41 |
| 2019 Enero | 22 | 11 | 33 |
| 2018 Diciembre | 19 | 4 | 23 |
| 2018 Noviembre | 17 | 6 | 23 |
| 2018 Octubre | 36 | 7 | 43 |
| 2018 Septiembre | 50 | 7 | 57 |
| 2018 Agosto | 12 | 6 | 18 |
| 2018 Julio | 2 | 9 | 11 |
| 2018 Junio | 14 | 2 | 16 |
| 2018 Mayo | 12 | 7 | 19 |
| 2018 Abril | 6 | 12 | 18 |
| 2018 Marzo | 13 | 7 | 20 |
| 2018 Febrero | 7 | 5 | 12 |
| 2018 Enero | 12 | 5 | 17 |
| 2017 Diciembre | 6 | 3 | 9 |
| 2017 Noviembre | 6 | 10 | 16 |
| 2017 Octubre | 6 | 14 | 20 |
| 2017 Septiembre | 12 | 8 | 20 |
| 2017 Agosto | 10 | 19 | 29 |
| 2017 Julio | 11 | 5 | 16 |
| 2017 Junio | 8 | 9 | 17 |
| 2017 Mayo | 15 | 12 | 27 |
| 2017 Abril | 22 | 12 | 34 |
| 2017 Marzo | 18 | 41 | 59 |
| 2017 Febrero | 13 | 9 | 22 |
| 2017 Enero | 7 | 13 | 20 |
| 2016 Diciembre | 20 | 12 | 32 |
| 2016 Noviembre | 30 | 33 | 63 |
| 2016 Octubre | 34 | 15 | 49 |
| 2016 Septiembre | 25 | 19 | 44 |
| 2016 Agosto | 16 | 9 | 25 |
| 2016 Julio | 17 | 9 | 26 |
| 2016 Junio | 12 | 15 | 27 |
| 2016 Mayo | 18 | 27 | 45 |
| 2016 Abril | 14 | 16 | 30 |
| 2016 Marzo | 17 | 24 | 41 |
| 2016 Febrero | 7 | 24 | 31 |
| 2016 Enero | 17 | 18 | 35 |
| 2015 Diciembre | 18 | 17 | 35 |
| 2015 Noviembre | 12 | 27 | 39 |
| 2015 Octubre | 26 | 25 | 51 |
| 2015 Septiembre | 24 | 27 | 51 |
| 2015 Agosto | 16 | 12 | 28 |
| 2015 Julio | 10 | 12 | 22 |
| 2015 Junio | 7 | 8 | 15 |
| 2015 Mayo | 13 | 11 | 24 |
| 2015 Abril | 10 | 21 | 31 |
| 2015 Marzo | 13 | 21 | 34 |
| 2015 Febrero | 27 | 11 | 38 |
| 2015 Enero | 32 | 2 | 34 |
| 2014 Diciembre | 50 | 7 | 57 |
| 2014 Noviembre | 36 | 4 | 40 |
| 2014 Octubre | 38 | 2 | 40 |
| 2014 Septiembre | 35 | 1 | 36 |
| 2014 Agosto | 29 | 3 | 32 |
| 2014 Julio | 41 | 3 | 44 |
| 2014 Junio | 37 | 1 | 38 |
| 2014 Mayo | 37 | 0 | 37 |
| 2014 Abril | 21 | 2 | 23 |
| 2014 Marzo | 35 | 1 | 36 |
| 2014 Febrero | 37 | 4 | 41 |
| 2014 Enero | 26 | 0 | 26 |
| 2013 Diciembre | 26 | 2 | 28 |
| 2013 Noviembre | 24 | 9 | 33 |
| 2013 Octubre | 36 | 16 | 52 |
| 2013 Septiembre | 20 | 15 | 35 |
| 2013 Agosto | 25 | 20 | 45 |
| 2013 Julio | 17 | 1 | 18 |
| 2007 Noviembre | 625 | 0 | 625 |
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