Incidencia de eventos adversos posquirúrgicos en un hospital de tercer nivel / Incidence of postoperative adverse events in a tertiary hospital

Objetivos. Determinar la proporción de reintervenciones, mortalidad, incidencia, gravedad y grado de evitabilidad de eventos adversos posquirúrgicos (EAP) en un hospital de tercer nivel. Métodos. Revisión retrospectiva de una muestra aleatoria de 350 cirugías realizadas en 2009 en pacientes mayores de 14 años. Para identificar los EAP, determinar su gravedad y establecer su grado de evitabilidad se utilizaron clasificaciones preestablecidas. Resultados. Se detectaron 113 EAP en 61 pacientes, el 17,4% de los 350 pacientes estudiados. El 4,3% de los pacientes fue reintervenido y la mortalidad a los 30 días fue del 2,6%. Los EAP más frecuentes fueron: infección de herida quirúrgica (15,0%), hematoma o hemorragia de herida (9,7%) y anemia por sangrado (8,8%). Los factores asociados a los pacientes que adquirieron un EAP fueron el uso anestesia general, grado ASA≥3, estancia media, edad media y servicios con cirugía de mayor repercusión sistémica. Cerca del 70% de los EAP estaban recogidos en el informe de alta. El 72,6% de EAP fueron de gravedad leve, el 11,5% de gravedad moderada y el 15,9% muy graves. Un 39,9% de EAP tenían una probabilidad alta de haberse evitado. No se encontró relación entre la evitabilidad y la gravedad de los EAP. Conclusiones. La alta proporción de pacientes intervenidos con EAP, las reintervenciones consecuentes y la mortalidad en el postoperatorio inmediato señalan la importancia de implantar acciones para reducir la magnitud y el impacto de los eventos adversos, teniendo en cuenta que más del 40% de los EAP podría ser evitado(AU)

Objectives. To determine the proportion of reoperations, mortality, incidence, severity and degree of preventability of postoperative adverse events (PAE) in a teaching hospital. Methods. Retrospective review a random sample of 350 surgical interventions realized in 2009 in patients over 14 years. To identify PAE, determine its severity and its degree of preventability, we used a previous classification. Results. Were detected PAE 113 in 61 patients, 17.4% of the 350 patients studied. 4.3% of patients were reoperated and mortality at 30 days was 2.6%. The most frequent PAE were: infection of surgical wound (15,0%), hematoma or hemorrhage of wound (9,7%) and anemia for bled (8,8%). The factors associated with the patients who acquire a PAE were the use general anesthesia, ASA>3, average stay, average age and more complex surgical services. About 70% of CP were included in the discharge report. The 72.6% of PAE were classified as mild in severity, 11.5% of moderate severity and 15.9% as very serious. 39,9% of the PAE had a high probability of having been avoided. One did not find relation between the preventability and the gravity of the PAE. Conclusions. The high proportion of patients surgically operated with PAE, the consequent reoperations and the mortality in the post operatory immediate indicates the importance of implementing actions to reduce the magnitude and impact of these adverse events, especially considering that over 40% of same could be avoided(AU)

[Incidence of postoperative adverse events in a tertiary hospital]. / Incidencia de eventos adversos posquirúrgicos en un hospital de tercer nivel.

OBJECTIVES: To determine the proportion of reoperations, mortality, incidence, severity and degree of preventability of postoperative adverse events (PAE) in a teaching hospital. METHODS: Retrospective review a random sample of 350 surgical interventions realized in 2009 in patients over 14 years. To identify PAE, determine its severity and its degree of preventability, we used a previous classification. RESULTS: Were detected PAE 113 in 61 patients, 17.4% of the 350 patients studied. 4.3% of patients were reoperated and mortality at 30 days was 2.6%. The most frequent PAE were: infection of surgical wound (15,0%), hematoma or hemorrhage of wound (9,7%) and anemia for bled (8,8%). The factors associated with the patients who acquire a PAE were the use general anesthesia, ASA>3, average stay, average age and more complex surgical services. About 70% of CP were included in the discharge report. The 72.6% of PAE were classified as mild in severity, 11.5% of moderate severity and 15.9% as very serious. 39,9% of the PAE had a high probability of having been avoided. One did not find relation between the preventability and the gravity of the PAE. CONCLUSIONS: The high proportion of patients surgically operated with PAE, the consequent reoperations and the mortality in the post operatory immediate indicates the importance of implementing actions to reduce the magnitude and impact of these adverse events, especially considering that over 40% of same could be avoided.