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Intensive Care Medicine

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01-06-2010 | Brief Report

Iatrogenic events contributing to ICU admission: a prospective study

Authors: Emmanuelle Mercier, Bruno Giraudeau, Guy Giniès, Dominique Perrotin, Pierre-François Dequin

Published in: Intensive Care Medicine | Issue 6/2010

Abstract

Objective

To determine the incidence, risk factors, severity, and preventability of iatrogenic events (IEs) as a cause of intensive care unit (ICU) admission.

Design

Comparison of patients admitted or not for IE. IE was diagnosed after assessing independently predefined criteria.

Setting

The ICU of a teaching hospital.

Patients

All patients consecutively admitted over 6 months.

Interventions

None.

Measurements and results

Characteristics of patients, supportive treatments, length of stay, and outcomes were recorded. For patients admitted for IE, cause, origin, and preventability of IE were assessed by consensus. Of 528 patients, 103 (19.5%) were admitted for IE. Their Simplified Acute Physiology Score (SAPS) II was higher (41.2 ± 22.6 versus 31.4 ± 18.6), as was their Logistic Organ Dysfunction (LOD) score. Surgical admissions and admission for shock were more frequent. The main risk factors were age, underlying disease, low Mac Cabe or Knaus score, number of physicians treating the patient, number of drugs prescribed, and other hospitalization within 1 month. Length of stay was higher (11.1 days versus 7.9 days, 0.5–6.0, p = 0.02). Catecholamine drugs, blood transfusion, and parenteral nutrition were more frequently required in the IE group. ICU mortality was 15.5% in the IE group and 11.3% in the group without IEs [not significant (ns) after adjustment]. IE was considered as probably preventable in 73.8% of cases.

Conclusion

Of admissions to the ICU, 19.5% resulted from IE, with high proportion of shock, leading to greater need for invasive treatments and longer stay in the ICU. Most cases of IE seemed preventable.

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Title: Iatrogenic events contributing to ICU admission: a prospective study
Authors: Emmanuelle Mercier
Bruno Giraudeau
Guy Giniès
Dominique Perrotin
Pierre-François Dequin
Publication date: 01-06-2010
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 6/2010
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-010-1793-9

At a glance: The STEP trials

Springer Medicine

Iatrogenic events contributing to ICU admission: a prospective study

Abstract

Objective

Design

Setting

Patients

Interventions

Measurements and results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Design

Setting

Patients

Interventions

Measurements and results

Conclusion

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