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. 2020 Dec;52(10):705-711.
doi: 10.1016/j.aprim.2020.02.008. Epub 2020 Jun 9.

[Avoidable adverse events in primary care. Retrospective cohort study to determine their frequency and severity]

[Article in Spanish]
Irene Carrillo  1 , José Joaquín Mira  2 , M Pilar Astier-Peña  3 , Pastora Pérez-Pérez  4 , Johanna Caro-Mendivelso  5 , Guadalupe Olivera  6 , Carmen Silvestre  7 , Aurora Mula  8 , María Ángeles Nuin  9 , Jesús M Aranaz-Andrés  10 ; en nombre del Grupo SOBRINA; Grupo SOBRINA
Collaborators, Affiliations

[Avoidable adverse events in primary care. Retrospective cohort study to determine their frequency and severity]

[Article in Spanish]
Irene Carrillo et al. Aten Primaria. 2020 Dec.

Abstract
in English, Spanish, Spanish

Objective: To determine the frequency of avoidable adverse events (AAEs) in Primary Care (PC).

Design: Retrospective cohort study.

Location: Family medicine and paediatric clinics in Andalusia, Aragon, Castilla-La Mancha, Catalonia, Madrid, Navarre, and Valencia.

Participants: A review was performed on a designated sample of 2,397 medical records (95% confidence level and 2% accuracy). The sample was stratified by age group as regards the frequency of physician consultations and considering equal distribution of male and female patients.

Main measurements: Number and severity of identified AAEs from February 2018 to September 2019.

Results: A total of 2,557 medical records were reviewed (1,928, 75.4% of adult patients, and 629, 24.6% paediatrics). A total of 182 (7.1%, 95% CI 6.1-8.1%) AAEs that affected 168 patients were identified, which included 7.6% (95% CI 6.4-8.8%) in adults and 5.7% (95% CI 3.9-7.5%) in paediatric patients. The number of AAEs in women was higher than in men (P = 0.006). The incidence of AAEs in boys and girls was similar (P = 0.3). Permanent damage was caused by AAEs in 6 (4.1%) adult patients.

Conclusions: Seeking formulas to increase patient safety in PC should remain a priority objective, particularly in female patients and in paediatrics. One in 24 AAEs causes serious and permanent damage in adults.

Objetivo: Determinar la frecuencia de eventos adversos evitables (EAE) en atención primaria (AP).

Diseño: Estudio retrospectivo de cohortes.

Emplazamiento: consultas de medicina de familia y pediatría de Andalucía, Aragón, Castilla La Mancha, Cataluña, Madrid, Navarra y Comunidad Valenciana.

Participantes: Se determinó revisar un mínimo de 2.397 historias clínicas (nivel de confianza del 95% y una precisión del 2%). La muestra se estratificó por grupos de edad de forma proporcional a su frecuentación y con revisión paritaria de historias de hombres y mujeres.

Mediciones principales: Número y gravedad de los EAE identificados entre febrero de 2018 y septiembre de 2019.

Resultados: Se revisaron un total de 2.557 historias clínicas (1.928, 75.4% de pacientes adultos y 629, 24.6% pediátricos). Se identificaron 182 EAE que afectaron a 168 pacientes (7,1%, IC 95% 6,1-8,1%); en adultos 7,6% (IC 95% 6,4-8,8%) y 5,7% (IC 95% 3,9-7,5%) en pacientes pediátricos. Las mujeres sufrieron más EAE que los hombres (p = 0,004). La incidencia de EAE en niños y niñas fue similar (p = 0,3). 6 (4.1%) de los EAE supusieron un daño permanente en pacientes adultos.

Conclusiones: Buscar fórmulas para incrementar la seguridad en AP, particularmente en pacientes mujeres, debe seguir siendo un objetivo prioritario incluso en pediatría. Uno de cada 24 EAE supone un daño grave y permanente en el adulto.

Puntos clave

  1. •

    Las intervenciones en seguridad del paciente, como las prácticas seguras, buscan reducir el número de incidentes para la seguridad de los pacientes, particularmente el número de eventos adversos evitables.

  2. •

    El número de eventos adversos evitables en atención primaria en España se ha duplicado con respecto a los datos aportados por el estudio APEAS (Estudio de la Seguridad de los Pacientes en atención primaria de Salud) realizado en 2008.

  3. •

    Uno de cada 30 eventos adversos evitables supone un daño grave y permanente en el adulto.

Keywords: Atención Primaria; Calidad asistencial; Cohort study; Errores médicos; Estudio de cohortes; Medical errors; Patient safety; Primary Care; Quality assurance; Seguridad del paciente.

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References

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