Unplanned intensive care admission leading to an adverse event: Incidence, preventability and feature analysis

Abstract

Objective: To compare the characteristics of patients between adverse event (AE) group and non-AE group, and to assess the causes, preventability, and severity of AE. Methods: A retrospective triple-phase medical record study was conducted at a Spanish tertiary hospital. Data was collected over a 6-month period, including all patients with an unplanned intensive care admission. Demographic characteristics, APACHE Π, length of ICU stay, mortality were compare between AE and non-AE group causes, preventability and severity were analyzed in AE cases. Results: 597 Patients were included in the study. The overall incidence of AEs was 17.3% (n=103), of which 83.5% were considered preventable. Mortality within the AE group was higher than in the non-AE group (23.3% vs. 13.6%), making it 1.7 times more frequent in the AE group (95% CI: 1.143-2.071). The primary cause of AE was associated with surgical procedures (43.7%). Of the AEs, 18.4% were classified as mild, 58.3% as moderate, and 23.3% as severe. Conclusions: The incidence of unplanned intensive care admissions due to AE is high and potentially preventable. This is concerning given the high mortality observed in patients admitted to the intensive care unit because of an AE, although direct causality cannot always be established. The findings emphasize the importance of patient safety and underscore the need for improved quality and management of care resources. They also indicate where efforts should be directed to enhance care risk management.