Admissions to the intensive care unit after complications of anaesthetic techniques over 10 years. 1. The first 5 years.
ABSTRACT Fifty-three patients were admitted in a 5-year period to the intensive care unit as a result of a complication of an anaesthetic technique. These patients represented 1 in 1543 anaesthetics carried out in the District in the period and 2.0% of all admissions to the intensive care unit. The mortality rate was 17%. The complication was considered to be wholly or partially avoidable in 14 instances (26%). Five of these subjects died and two had a residual neurological deficit.
Article: Validity of unplanned admission to an intensive care unit as a measure of patient safety in surgical patients.[show abstract] [hide abstract]
ABSTRACT: An unplanned admission to the intensive care unit within 24 h of a procedure (UIA) is a recommended clinical indicator in surgical patients. Often regarded as a surrogate marker of adverse events, it has potential as a direct measure of patient safety. Its true validity for such use is currently unknown. The authors validated UIA as an indicator of safety in surgical patients in a prospective cohort study of 44,130 patients admitted to their hospital. They assessed the association of UIA with intraoperative incidents and near misses, increased hospital length of stay, and 30-day mortality as three constructs of patient safety. The authors identified 201 patients with a UIA; 104 (52.2%) had at least one incident or near miss. After adjusting for confounders, these incidents were significantly associated with UIA in all categories of surgical procedures analyzed; odds ratios were 12.21 (95% confidence interval [CI], 6.33-23.58), 4.06 (95% CI, 2.74-6.03), and 2.13 (95% CI, 1.02-4.42), respectively. The 30-day mortality for patients with UIA was 10.9%, compared with 1.1% in non-UIA patients. After risk adjustment, UIA was associated with excess mortality in several types of surgical procedures (odds ratio, 3.89; 95% CI, 2.14-7.04). The median length of stay was increased if UIA occurred: 16 days (interquartile range, 10-31) versus 2 days (interquartile range, 0.5-9) (P < 0.001). For patients with a UIA, the likelihood of discharge from hospital was significantly decreased in most surgical categories analyzed, with adjusted hazard ratios of 0.41 (95% CI, 0.23-0.77) to 0.58 (95% CI, 0.37-0.93). These findings provide strong support for the construct validity of UIA as a measure of patient safety.Anesthesiology 12/2005; 103(6):1121-9. · 5.36 Impact Factor