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; 吴林格尔; 黄会真; 张越伦; 鲁志龙; 田亚杰; 申乐; 黄宇光

doi:10.24920/004130

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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

中国医学科学杂志（英文版） 2022年37卷第4期页码：287-292

Original article | Updated：2024-04-10

- 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
- Affiliations：
  
  1. 1Department of Anesthesiology, Beijing 100730, China
  2. 2Medical Research Center;Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
- Author bio：
  
  * 86-10-69152026, E-mail: pumchshenle@163.com
- Funds：
- DOI：10.24920/004130
  中图分类号：
- 收稿日期：2022-06-23，
  
  录用日期：2022-9-30，
  
  网络出版日期：2022-10-10，
  
  纸质出版日期：2022-12-31
- Accepted：
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张雪, 吴林格尔, 黄会真, 等. 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[J]. 中国医学科学杂志（英文版）, 2022,37(4):287-292.

Xue Zhang, Lingeer Wu, Huizhen Huang, et al. Risk Factors for Anesthesia-Related Airway Patient Safety Incidents: A Single-Center Retrospective Case-Control Analysis from 2009 to 2022[J]. Chinese medical sciences journal, 2022, 37(4): 287-292.
张雪, 吴林格尔, 黄会真, 等. 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[J]. 中国医学科学杂志（英文版）, 2022,37(4):287-292. DOI： 10.24920/004130.

Xue Zhang, Lingeer Wu, Huizhen Huang, et al. Risk Factors for Anesthesia-Related Airway Patient Safety Incidents: A Single-Center Retrospective Case-Control Analysis from 2009 to 2022[J]. Chinese medical sciences journal, 2022, 37(4): 287-292. DOI： 10.24920/004130.

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（

= 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%

：0.29~0.82，

0.001）、ICU住院日（1.63 ± 5.71 d比0.19 ± 0.84 d，95%

：0.57~2.32，

= 0.001）及总住院日（14.99 ± 15.18 d比11.62 ± 11.88 d，95%

：0.46~6.27，

= 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。

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 (

= 0.020). Patients with airway PSIs reported had longer extubation time (0.72 ± 1.56 d

. 0.16 ± 0.77 d

95%

: 0.29 to 0.82

0.001)

longer ICU length of stay (LOS) (1.63 ± 5.71 d

. 0.19 ± 0.84 d

95%

: 0.57 to 2.32

= 0.001)

longer post operative LOS (10.56 ± 13.09 d

. 7.59 ± 10.76 d

95%

: 0.41 to 5.53

= 0.023)

and longer total in-hospital LOS (14.99 ± 15.18 d

. 11.62 ± 11.88 d

95%

: 0.46 to 6.27

= 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.

关键词

Keywords

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