scholarly journals Comparison of two methods to estimate adverse events in the IBEAS Study (Ibero-American study of adverse events): cross-sectional versus retrospective cohort design

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e016546 ◽  
Author(s):  
Jesus Maria Aranaz Andrés ◽  
Ramon Limón Ramírez ◽  
Carlos Aibar Remón ◽  
Maria Teresa Gea-Velázquez de Castro ◽  
Francisco Bolúmar ◽  
...  
Keyword(s):  
Cohort Study ◽  
Adverse Events ◽  
Retrospective Cohort Study ◽  
Medical Records ◽  
Retrospective Cohort ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Hospital Size ◽  
Cohort Design ◽  
Cohort Study Design

BackgroundAdverse events (AEs) epidemiology is the first step to improve practice in the healthcare system. Usually, the preferred method used to estimate the magnitude of the problem is the retrospective cohort study design, with retrospective reviews of the medical records. However this data collection involves a sophisticated sampling plan, and a process of intensive review of sometimes very heavy and complex medical records. Cross-sectional survey is also a valid and feasible methodology to study AEs.ObjectivesThe aim of this study is to compare AEs detection using two different methodologies: cross-sectional versus retrospective cohort design.SettingSecondary and tertiary hospitals in five countries: Argentina, Colombia, Costa Rica, Mexico and Peru.ParticipantsThe IBEAS Study is a cross-sectional survey with a sample size of 11 379 patients. The retrospective cohort study was obtained from a 10% random sample proportional to hospital size from the entire IBEAS Study population.MethodsThis study compares the 1-day prevalence of the AEs obtained in the IBEAS Study with the incidence obtained through the retrospective cohort study.ResultsThe prevalence of patients with AEs was 10.47% (95% CI 9.90 to 11.03) (1191/11 379), while the cumulative incidence of the retrospective cohort study was 19.76% (95% CI 17.35% to 22.17%) (215/1088). In both studies the highest risk of suffering AEs was seen in Intensive Care Unit (ICU) patients. Comorbid patients and patients with medical devices showed higher risk.ConclusionThe retrospective cohort design, although requires more resources, allows to detect more AEs than the cross-sectional design.

scholarly journals General versus regional anaesthesia for caesarean section indicated for acute foetal distress: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Junette Arlette Mbengono Metogo ◽  
Theophile Njamen Nana ◽  
Brian Ajong Ngongheh ◽  
Emelinda Berinyuy Nyuydzefon ◽  
Christoph Akazong Adjahoung ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Retrospective Cohort Study ◽  
Medical Records ◽  
Regional Anaesthesia ◽  
Retrospective Cohort ◽  
Statistical Significance ◽  
Neonatal Resuscitation ◽  
Maternal Outcomes ◽  
Foetal Distress

Abstract Background Acute foetal distress (AFD) is a life-threatening foetal condition complicating 2% of all pregnancies and accounting for 8.9% of caesarean sections (CS) especially in developing nations. Despite the severity of the problem, no evidence exists as to the safest anaesthetic technique for the mother and foetus couple undergoing CS for AFD. We aimed to compare general anaesthesia (GA) versus regional (spinal and epidural) anaesthesia in terms of their perioperative maternal and foetal outcomes. Methods We carried out a retrospective cohort study by reviewing the medical records of all women who underwent CS indicated for AFD between 2015 to 2018 at the Douala General Hospital, Cameroon. Medical records of neonates were also reviewed. We sought to investigate the association between GA, and regional anaesthesia administered during CS for AFD and foetal and maternal outcomes. The threshold of statistical significance was set at 0.05. Results We enrolled the medical records of 117 pregnant women who underwent CS indicated for AFD. Their mean age and mean gestational age were 30.5 ± 4.8 years and 40 weeks respectively. Eighty-three (70.9%), 29 (24.8%) and 05 (4.3%) pregnant women underwent CS under SA, GA and EA respectively. Neonates delivered by CS under GA were more likely to have a significantly low APGAR score at both the 1st (RR = 1.93, p = 0.014) and third-minute (RR = 2.52, p = 0.012) and to be resuscitated at birth (RR = 2.15, p = 0.015). Past CS, FHR pattern on CTG didn’t affect these results in multivariate analysis. Adverse maternal outcomes are shown to be higher following SA when compared to GA. Conclusion The study infers an association between CS performed for AFD under GA and foetal morbidity. This, however, failed to translate into a difference in perinatal mortality when comparing GA vs RA. This finding does not discount the role of GA, but we emphasize the need for specific precautions like adequate anticipation for neonatal resuscitation to reduce neonatal complications associated with CS performed for AFD under GA.

scholarly journals Adverse events in a Tunisian hospital: results of a retrospective cohort study

2010 ◽  
Vol 22 (5) ◽  
pp. 380-385 ◽  
Author(s):  
Mondher Letaief ◽  
Sana El Mhamdi ◽  
Riham El-Asady ◽  
Sameen Siddiqi ◽  
Ahmed Abdullatif
Keyword(s):  
Cohort Study ◽  
Adverse Events ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort

ECMO Transport without Physicians or Additional Clinicians

2020 ◽  
pp. 1-7
Author(s):  
Anna Condella ◽  
Jeremy B. Richards ◽  
Michael A. Frakes ◽  
Christian J. Grant ◽  
Jason E. Cohen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Adverse Events ◽  
Nurse Practitioner ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Primary Outcome ◽  
Secondary Outcome ◽  
Hub And Spoke ◽  
Current Guidelines ◽  
Major Adverse Events

Abstract Background: Extracorporeal membrane oxygenation (ECMO) has accelerated rapidly for patients in severe cardiac or respiratory failure. As a result, ECMO networks are being developed across the world using a “hub and spoke” model. Current guidelines call for all patients transported on ECMO to be accompanied by a physician during transport. However, as ECMO centers and networks grow, the increasing number of transports will be limited by this mandate. Objectives: The aim of this study was to compare rates of adverse events occurring during transport of ECMO patients with and without an additional clinician, defined as a physician, nurse practitioner (NP), or physician assistant (PA). Methods: This is a retrospective cohort study of all adults transported while cannulated on ECMO from 2011-2018 via ground and air between 21 hospitals in the northeastern United States, comparing transports with and without additional clinicians. The primary outcome was the rate of major adverse events, and the secondary outcome was minor adverse events. Results: Over the seven-year study period, 93 patients on ECMO were transported. Twenty-three transports (24.7%) were accompanied by a physician or other additional clinician. Major adverse events occurred in 21.5% of all transports. There was no difference in the total rate of major adverse events between accompanied and unaccompanied transports (P = .91). Multivariate analysis did not demonstrate any parameter as being predictive of major adverse events. Conclusions: In a retrospective cohort study of transports of ECMO patients, there was no association between the overall rate of major adverse events in transport and the accompaniment of an additional clinician. No variables were associated with major adverse events in either cohort.

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