Factors associated with the occurrence of adverse events in critical elderly patients

Toffoletto, Maria Cecilia; Barbosa, Ricardo Luis; Andolhe, Rafaela; Oliveira, Elaine Machado de; Janzantte Ducci, Adriana; Padilha, Katia Grillo

doi:10.1590/0034-7167-2016-0199

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Sumário

RESEARCH • Rev. Bras. Enferm. 69 (6) • Nov-Dec 2016 • https://doi.org/10.1590/0034-7167-2016-0199 copy

Factors associated with the occurrence of adverse events in critical elderly patients

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to identify the factors associated with the occurrence of adverse events in critical elderly patients admitted to intensive care unit according to demographic and clinical characteristics.

Method:

a retrospective cohort study was conducted in nine units of a teaching hospital. Data were collected from medical records and from monitoring of nursing shift change. We used the t-test/Mann-Whitney, chi-square and logistic regression to test associations. Significance level of 5% was used.

Results:

out of the 315 elderly, 94 experienced events. Those who experienced events were men (60.6%) with mean age of 70.7 years, length of hospital stay of 10.6 days and survivors (61.7%). Most of the 183 events were clinical processes and procedures (37.1%). There was an association between adverse event and length of hospital stay in the unit (p=0.000; OR=1.10, 95% CI [1.06, 1.14]).

Conclusion:

the identification of associated events and factors in the elderly subsidize the prevention of these occurrences before the vulnerability of this age group.

Descriptors:
Aged; Intensive Care Units; Patient Safety; Nursing Care; Workload

Variabless	Adverse Event	n	Mean	Standard deviation	p value
	No	221	71.53	8.20
Age	Yes	94	70.76	7.84	0.438^* * t test;
	Total	315	71.30	8.09
	No	221	5.06	6.48
Length of hospital stay	Yes	94	10.62	9.30	0.000^† † Mann-Whitney
	Total	315	6.72	7.84
	No	221	71.20	13.50
Nursing Activities Score	Yes	94	74.27	15.95	0.082^* * t test;
	Total	315	72.12	14.32
	No	221	0.17	0.20
Simplified Acute Physiology Score-II	Yes	94	0.22	0.24	0.167^† † Mann-Whitney
	Total	315	0.18	0.21
	No	221	1.76	1.85
Charlson	Yes	94	2.11	2.24	0.150^† † Mann-Whitney
	Total	315	1.86	1.98

Variables		Adverse Event
		No		Yes
		n	%	n	%	p
	Notcritical	148	66.9	50	53.2
Admission	Criticalstage	73	33.1	44	46.8	0.021
	Total	221	100	94	100
	Survival	168	76.0	58	61.7
Discharge	No survivor	53	24.0	36	38.3	0.010
	Total	221	100	94	100

Types of moderate and severe adverse events	n	%
Clinical process/procedure	68	37.1
Patient accidents	57	31.1
Healthcare-associated infection	45	24.5
Clinicaladministration	6	3.2
Medication/IV or fluids for administration	4	2.5
Medical device/equipment	2	1.1
Resources/organizational management	1	0.5
Total	183	100

Typeofharm	n	%
Physiopatology	100	54.7
Injury	72	39.3
Other	11	6.0
Total	183	100

Variable	Beta	Odds Ratio	95% CI		p value
Lengthofhospital stay	0.10	1.10	1.06	1.14	0.000
Constant	-1.94	0.14

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[1] CORRESPONDING AUTHOR: Maria Cecilia Toffoletto. E-mail: mtoffoletto@unab.cl