[Iatrogenic events: a significant cause of admission in intensive care units]

Abstract

Objective: Identification and analysis of iatrogenic events leading to admission in intensive care units.

Study design: Prospective observational monocentric study.

Patients: Critically ill patients hospitalized in adult medical intensive care unit of a general hospital over a twelve-month period.

Methods: We recorded for each patient the following characteristics: origin, demographic datas, cause of admission, medical background, severity, diagnosis, ICU length of stay and provided treatments. Two medical investigators identified the iatrogenic character of events and determined their potential preventability. Univariate statistical analysis was performed.

Results: During the study period, 603 patients were admitted and 71 (12%) due to iatrogenic events. In comparison to patients hospitalized for other causes, these patients were older (66 years vs. 60, P 0.009) and often previously treated in a hospital (82% vs. 54%, P<0.0001). They had increased need for transfusions (39% vs. 26%, P 0.02) but less frequent indications for mechanical ventilation (67% vs. 77%, P 0.07). They had similar ICU mortality (20% vs. 19%). Among them, 27 iatrogenic events were considered as preventable.

Conclusions: Iatrogenic event is a significant cause of ICU admission, involved in 12% of all the hospitalizations in our unit. It has an impact on the patient's profile (significantly older) and their ICU stay (increased need for transfusion). More than a third of events could be preventable and potentially accessible to corrective actions.

Keywords: Admission; Adverse event; Hospitalisation; Hospitalization; ICU admission; Iatrogenic disease; Iatrogenic event; Iatrogénie; Réanimation; Événement indésirable grave.