Chinese Medical Sciences Journal ›› 2022, Vol. 37 ›› Issue (4): 287-292.doi: 10.24920/004130

• •    下一篇

麻醉相关气道不良事件相关因素分析:一项2009至2022年单中心回顾性病例对照研究

张雪1,吴林格尔1,黄会真1,张越伦2,鲁志龙1,田亚杰1,申乐1,*(),黄宇光1   

  1. 1中国医学科学院北京协和医院麻醉科,北京 100730
    2医学研究中心,北京 100730
  • 收稿日期:2022-06-23 接受日期:2022-09-30 出版日期:2022-12-31 发布日期:2022-10-10
  • 通讯作者: 申乐 E-mail:pumchshenle@163.com

Risk Factors for Anesthesia-Related Airway Patient Safety Incidents: A Single-Center Retrospective Case-Control Analysis from 2009 to 2022

Xue Zhang1,Lingeer Wu1,Huizhen Huang1,Yuelun Zhang2,Zhilong Lu1,Yajie Tian1,Le Shen1,*(),Yuguang Huang1   

  1. 1Department of Anesthesiology, Beijing 100730, China
    2Medical Research Center;Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
  • Received:2022-06-23 Accepted:2022-09-30 Published:2022-12-31 Online:2022-10-10
  • Contact: Le Shen E-mail:pumchshenle@163.com

摘要:

目的 麻醉相关气道不良事件是麻醉医师最关注的不良事件类型,此类不良事件若处理不及时或不恰当,可能严重威胁患者生命安全。本研究旨在分析麻醉医师上报气道不良事件的组成及患者预后,并寻找可能的相关危险因素。
方法 我们采集了所有北京协和医院2009年9月至2022年5月由麻醉医师在系统中上报的气道相关不良事件数据。发生气道不良事件的病例按照相同性别及相同手术类型与未发生不良事件病例进行1:1匹配。我们通过单因素及多因素分析方法,寻找与气道不良事件发生相关的危险因素,并分析气道不良事件对患者预后的影响。
结果 在研究期间,麻醉医师共在系统中上报不良事件1,038例,其中281例(27.1%)为气道相关不良事件,整体上报率为4.74/10,000。仅ASA分级是发生此类不良事件的独立相关因素(P = 0.002)。发生气道相关不良事件的患者拔管时间(0.72 ± 1.56 d比0.16 ± 0.77 d,95%CI:0.29~0.82,P < 0.001)、ICU住院日(1.63 ± 5.71 d比0.19 ± 0.84 d,95%CI:0.57~2.32,P = 0.001)及总住院日(14.99 ± 15.18 d比11.62 ± 11.88 d,95%CI:0.46~6.27,P = 0.024)均显著延长。
结论 本单中心回顾性病例对照研究描述了13年间麻醉医师上报气道相关不良事件的组成。气道不良事件可能通过延长拔管时间及住院日影响患者预后。气道相关不良事件值得更多关注,以保障患者安全。

关键词: 组成, 危险因素, 气道, 不良事件

Abstract:

Objective Airway-related patient safety incident (PSI) has always been the top concern of anesthesiologists because this type of incidents could severely threaten patient safety if not treated immediately and properly. This study intends to reveal the composition, prognosis, and to identify risk factors for airway related incidents reported by anesthesiologists.
Methods All airway related PSIs reported by anesthesiologists in a Chinese academic hospital between September 2009 and May 2022 were collected from the PSI reporting system. Patients with airway incidents reported were matched 1:1 with controls based on sex and type of surgery. Univariable and multivariable analysis were performed to find risk factors associated with airway incident occurrence, and to evaluate influence of airway PSIs on patient prognosis.
Results Among 1,038 PSIs voluntarily reported by anesthesiologists during the study period, 281 cases (27.1%) were airway-related incidents, with an overall reporting incidence of 4.74 per 10,000 among 592,884 anesthesia care episodes. Only ASA physical status was found to be significant independent predictor of these airway PSIs (P = 0.020). Patients with airway PSIs reported had longer extubation time (0.72 ± 1.56 d vs. 0.16 ± 0.77 d, 95%CI: 0.29 to 0.82, P < 0.001), longer ICU length of stay (LOS) (1.63 ± 5.71 d vs. 0.19 ± 0.84 d, 95%CI: 0.57 to 2.32, P= 0.001), longer post operative LOS (10.56 ± 13.09 d vs. 7.59 ± 10.76 d, 95%CI: 0.41 to 5.53, P = 0.023), and longer total in-hospital LOS (14.99 ± 15.18 d vs. 11.62 ± 11.88 d, 95%CI: 0.46 to 6.27,P = 0.024).
Conclusions This single-center retrospective case-control study describes the composition of airway-related PSIs reported by anesthesiologists within thirteen years. Airway incidents might influence patient prognosis by elongating extubation time and LOS. Airway PSI data were worth analyzing to improve patient safety.

Key words: composition, risk factor, airway, patient safety incident

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