Unplanned intensive care admission leading to an adverse event:Incidence,preventability and feature analysis

Objective:To compare the characteristics of patients between adverse event(AE)group and non-AE group,and to assess the causes,preventability,and severity of AE.Methods:A retrospective triple-phase medical record study was conducted at a Spanish tertiary hospital.Data was collected over a 6-month period,including all patients with an unplanned intensive care admission.Demographic characteristics,APACHEⅡ,length of ICU stay,mortality were compare between AE and non-AE group causes,preventability and severity were analyzed in AE cases.Results:597 Patients were included in the study.The overall incidence of AEs was 17.3%(n=103),of which 83.5%were considered preventable.Mortality within the AE group was higher than in the non-AE group(23.3%vs.13.6%),making it 1.7 times more frequent in the AE group(95%CI:1.143-2.071).The primary cause of AE was associated with surgical procedures(43.7%).Of the AEs,18.4%were classified as mild,58.3%as moderate,and 23.3%as severe.Conclusions:The incidence of unplanned intensive care admissions due to AE is high and potentially preventable.This is concerning given the high mortality observed in patients admitted to the intensive care unit because of an AE,although direct causality cannot always be established.The findings emphasize the importance of patient safety and underscore the need for improved quality and management of care resources.They also indicate where efforts should be directed to enhance care risk management.

What the Hell Am I Doing Here？ A Look at a Series of Geriatric Centers, Profile of the Institutionalized Persons and Reasons for Admission

The main objective of this study was always to know the profile of the institutionalized people in our environment, to know their reality： age, age of admission, level of dependency and evolution during their stay, years of stay, number of children, reason for admission. We use data from more than 600 patients from different residences of different backgrounds： public and private, lay and religious, rural and urban. We performed a descriptive study expressing the results in percentages with standard deviation and later evaluated the statistical significance of the differences using the student＇s t-test for the quantitative and Chi-square variables to compare qualitative variables. The results of the study are numerous and of diverse nature, because of their extension, from the general profile of the resident, to the important gender differences, attributed in principle to the different roles of each gender in the studied generations. There are also differences depending on the funding, the reason for admission or the environment. This is at the end only the beginning of a large comparative study with non-institutionalized population, in order to compare this population.

The Influence of Initial Management and Family Stress on Metabolic Control in Children with Type 1 Diabetes

The aim was to assess whether temporal changes in the initial management for children diagnosed with type 1 diabetes over a ten year period affected metabolic control two years after diagnosis. A further aim was to investigate if social factors, registered at diagnosis, had an impact on metabolic control two years after diagnosis. During the years 1997-2006, 247 children and adolescents were diagnosed with type 1 diabetes at a University Hospital in Sweden. The analysed data included HbA1c, pH at diagnosis, initial intravenous insulin infusion and length of hospital stay at diag?nosis, subcutaneous insulin type, number of diabetes check-up visits, emergency visits, re-admissions and social factors. Length of hospital stay decreased significantly over the ten year period. Neither hospital stay nor differences in insulin treatment was significantly correlated with children’s metabolic control over time. Length of hospital stay was not re?lated with families’ social stress situation. However, girls in families with more family stress at the time of diagnosis had higher HbA1c during follow-up than girls with less family stress or boys. Factors of importance for the child’s long-term metabolic control need to be further investigated so the initial management can be tailored to each individual family’s needs. This would imply an effective utilization of both families’ and health care resources.