Eventos adversos hospitalarios en medicina interna

Resumen

ABSTRACT Background Since most studies carried out so far on adverse events (AE) are retrospective and focus on describing these events, this study aims to assess the incidence of AEs in an Internal Medicine unit, describe the profile of patients with AEs and evaluate their consequences and preventability. Methods We performed a single-cohort prospective observational study using a mixed source of data, a primary (prospective) source and a secondary source (clinical record). Results We analyzed 667 patients with an average age of 69, generating 714 admissions. The unit of analysis was hospitalization. In total, the 714 admissions generated 140 AEs linked to healthcare. 104 admissions presented AEs, with an incidence of 14.6% (104/714); 95% confidence interval [CI]: 12.06%-17.37%. The most frequent AEs were the ones related to medication (38%), followed by nosocomial infection (21%) and those related to a procedure (21%). Independent factors for AE development were: age over 65 (odds ratio [OR] = 1.9, 95% CI: 1.1-3.4), coronary heart disease (OR = 2.1, 95% CI: 1.2-3.6), urinary catheter (OR = 2.3, 95% CI: 1.4-3.8) and central venous catheter (OR = 4.6, 95 % CI: 1.5-13.7). The preventability rate was 37.5%. Conclusions The incidence of AEs detected in our Internal Medicine Unit is higher than that found in other studies, although within the established limits. There are few studies with similar characteristics (prospective studies with a daily observation of a cohort of patients). Comorbidity and the error in the use of clinical guidelines and are the most relevant causative/contributory factors.