[Adverse events in ambulatory surgical procedures]. / Efectos adversos en cirugía mayor ambulatoria.

OBJECTIVE: To assess the incidence of adverse events and patients with adverse events in ambulatory surgical procedures and to compare it with that of other studies. MATERIAL AND METHOD: Historical cohort study. The scope of the study was the ambulatory surgical procedures unit of a university hospital. All general surgery department patients seen in this unit during the year 2005 were included. RESULTS: The incidence of patients with adverse events directly related to hospital care was of 3% (95% CI, 0.9-5). Of the adverse events identified 5 were considered slight, 3 moderate and none were considered serious. All the moderate ones were considered unavoidable and of slight, only the one was avoidable. Six of the adverse events were associated to a procedure, one due to hospital infections and one with other causes. There was an increase in hospital stay due to 75% of the adverse events, and 25% of them affected admission. CONCLUSIONS: The incidence of adverse events related to medical care in the Spanish hospitals is similar to those found in the studies carried out in American and European countries using the same methodology. The surgical area is considered a high risk unit. However, ambulatory surgical procedures reduce these risks, in such a way that the incidence is far below that of surgery department. Therefore, besides improving the technical efficiency of the clinical services, it is safer for the patients.

Efectos adversos en cirugía mayor ambulatoria / Adverse events in ambulatory surgical procedures

Objetivo. Determinar la incidencia de efectos adversos y de pacientes con efectos adversos en cirugía mayor ambulatoria y compararla con la incidencia encontrada en los servicios de cirugía general incluidos en el estudio ENEAS. Material y método. Estudio de cohortes históricas. El ámbito del estudio fue la unidad de cirugía mayor ambulatoria de un hospital universitario. Se incluyó a todos los pacientes atendidos en el servicio de cirugía general durante el año 2005. Resultados. La incidencia de pacientes con efectos adversos relacionados directamente con la asistencia sanitaria fue del 3% (intervalo de confianza del95%, 0,9-5). De los 8 efectos adversos detectados, 5se consideraron leves, 3 moderados y ninguno grave. Todos los moderados se consideraron inevitables y de los leves tan sólo uno era evitable. Entre los efectos adversos, 6 tuvieron relación con un procedimiento, uno con infección nosocomial y otro con otras causas. Tres cuartas partes de los efectos adversos tuvieron como consecuencia un incremento de la estancia y en una cuarta parte el efecto adverso condicionó el ingreso. Conclusiones. La incidencia de efectos adversos relacionados con la asistencia sanitaria en los hospitales españoles es similar a la de los estudios realizados en países americanos y europeos con similar metodología. Se considera que el área quirúrgica es de alto riesgo para desencadenarlos; sin embargo, la cirugía mayor ambulatoria reduce su incidencia. Por lo tanto, además de mejorar la eficiencia técnica de los servicios clínicos, es más segura para los pacientes (AU)

Objective. To assess the incidence of adverse events and patients with adverse events in ambulatory surgical procedures and to compare it with that of other studies. Material and method. Historical cohort study. The scope of the study was the ambulatory surgical procedures unit of a university hospital. All general surgery department patients seen in this unit during the year 2005 were included. Results. The incidence of patients with adverse events directly related to hospital care was of 3% (95% CI, 0.9-5). Of the adverse events identified 5 were considered slight, 3 moderate and none were considered serious. All the moderate ones were considered unavoidable and of slight, only the one was avoidable. Six of the adverse events were associated to a procedure, one due to hospital infections an done with other causes. There was an increase in hospital stay due to 75% of the adverse events, and 25%of them affected admission. Conclusions. The incidence of adverse events related to medical care in the Spanish hospitals is similar to those found in the studies carried out in American and European countries using the same methodology. The surgical area is considered a high risk unit. However, ambulatory surgical procedures reduce these risks, in such a way that the incidence is far below that of surgery department. Therefore, besides improving the technical efficiency of the clinical services, itis safer for the patients (AU)