Screening of adverse events (AE) in obstetric attention and puerperium at the Instituto Materno Infantil, Bogotá, Colombia, 2002-2003
DOI:
https://doi.org/10.18597/rcog.555Keywords:
maternal mortality, adverse effects, morbidity, epidemiology, Health Care Quality, Access, and EvaluationAbstract
Introduction: most births in Colombia are institutional; however, maternal and perinatal morbidity-mortality is high. The results of maternal attention are partly determined by suitable attention regarding complications. Given that maternal morbidity-mortality is avoidable in an important number of cases, determining intra-hospital adverse events (AE) impact on it would seem to be extremely pertinent. Not having apposite data limits its analysis. The present work is aimed at describing AE screening frequency, in maternal attention and their relationship with maternal morbidity-mortality in a third level institution and perinatal maternal attention referral centre in Bogotá.
Materials and methods: prospective epidemiological surveillance study, in pregnant mothers being admitted to the Instituto Materno Infantil (IMI) from November 2002 to October 2003. Patients having alterations in their pregnancy or during giving birth were included. Women were excluded who gave birth in another institution. The frequency of adverse events and associated factors are described. Single-variable analysis was carried out for establishing association with clinical or hospital variables using Student’s t-test or Ji2 test having 95% confidence interval.
Results: 2,530 women were included. There was 12.02% incidence of adverse events during hospitalization. Patients had a greater risk of presenting adverse events if their gestation was less advanced, were suffering maternal morbidity on being admitted (1.63 RR; 1.06–2.53 95% CI) and organic dysfunction on being admitted (3.2 RR; 2.53–4.07 95% CI). Patients who underwent caesarean section had (1.81 RR; 1.4–2.41 95% IC) of presenting adverse events, compared to those giving birth vaginally. Hospital stay was significantly greater in the group of patients presenting adverse events: 4 days (0 - 30) versus 2.00 days (0 -30).
Conclusions: adverse events are associated with maternal morbidity and are related to maternal and hospital factors.
Author Biographies
Hernando Gaitán D.
Javier Eslava S.
Carmen Doris Garzón O.
Jorge Andrés Rubio
Jaime Forero G.
Luis Guillermo Valbuena
Aída del Pilar Vargas
Darío Sotelo R.
Alberto Páez
References
Maternal mortality in 2000. Estimates developed by WHO, UNICEF and UNFPA. Disponible en: http://www.who.int/reproductive-health/publications/maternal_mortality_2000/executive_summary.html. Consultado el 30 de Septiembre de 2004.
Stopping the invisible epidemic of maternal deaths. World Health Organization. Disponible en: http://www.who.int/mediacentre/news/releases/2004/pr65/en/. Consultado el 30 de Septiembre de 2004.
Ministerio de Protección Social, República de Colombia. Indicadores Básicos de Salud 2002. Disponible en: http://www.minproteccionsocial.gov.co/MseContent/newsdetail.asp?id=11423&idcompany=1. Consultado el 24 de Febrero de 2005.
Salazar A, Vásquez ML. Mortalidad Materna en Cali ¿Una década sin cambios? Colombia Med 1996;27:117-24.
Ollenschlager G, Thomeczek C. Quality management in health care: error prevention and managing errors in medicine. Med Klin 2002;97:564-70.
Baker GR, Norton PG, Flintoft V, Blais R, Brown A, Cox J, et al. The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada. CMAJ 2004;170;1678-86.
Clasificación Internacional de Enfermedades. Definición ICD-10. Disponible en: http://www.iqb.es/patologia/e-m.htm. Consultado el 23 de febrero de 2005.
World Health Organization. Reduction of maternal mortality. A Joint WHO/UNFPA/UNICEF. World Bank Statement. Geneve; 1999.
Thomas EJ, Studdert DM, Newhouse JP, Zbar BI, Howard KM, Williams EJ, et al. Costs of medical injuries in Utah and Colorado. Inquiry 1999;36:255-64.
Leape LL, Brennan TA, Laird NM, Lawthers AG, Localio AR, Barnes BA, et al. Incidence of adverse events and negligence in hospitalised patients: results of the Harvard medical practice study II. N Engl J Med 1991;324:377-84.
Vincent C, Neale G, Woloshynowych M. Adverse events in British hospitals: preliminary retrospective record review. BMJ 2001;322:517-9.
Thomas EJ, Brennan TA. Incidence and types of preventable adverse events in elderly patients: population based review of medical records.BMJ 2000;320:741-4.
von Laue NC, Schwappach DL, Koeck CM. The epidemiology of medical errors: a review of the literature. Wien Klin Wochenschr 2003;115:318-25.
Michel P, Quenon JL, de Sarasqueta AM, Scemama O. Comparison of three methods for estimating rates of adverse events and rates of preventable adverse events in acute care hospitals. BMJ 2004;328:199.
Davis P, Lay-Yee R, Briant R, Ali W, Scott A, Schug S. Adverse events in New Zealand public hospitals II: preventability and clinical context. N Z Med J 2003;116:U624.
How to Cite
Downloads
Downloads
Published
Issue
Section
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
