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Preventable morbidity at a mature trauma center
Pedro G R Teixeira1, Kenji Inaba, Ali Salim
1Division of Trauma Surgery and Surgical Critical Care, University of Southern California, Los Angeles, CA 90033, USA.
Archives of Surgery (Chicago, Ill. : 1960)
|June 17, 2009
Summary
Preventable complications at trauma centers are rare but significant. Key areas for improvement include unintended extubation, surgical errors, missed injuries, and catheter issues.
Area of Science:
- Trauma Surgery
- Patient Safety
- Quality Improvement
Background:
- Trauma centers aim to minimize patient harm.
- Understanding preventable complications is crucial for enhancing care.
Purpose of the Study:
- To analyze preventable and potentially preventable complications at a Level I trauma center.
- Identify common types and impact of these complications.
Main Methods:
- Retrospective review of 35,311 trauma registry patients over 8 years.
- Data collected from trauma registry and medical records.
- Complications categorized by cause, outcome effect, and preventability.
Main Results:
- 351 patients (0.99%) experienced 403 preventable/potentially preventable complications.
- Most common: unintended extubation (17%), surgical technical failures (15%), missed injuries (14%), catheter-related (12%).
- 64% of these complications led to changes in management, including surgery and reintubation.
Conclusions:
- The incidence of preventable complications at this trauma center is low.
- Four categories require focus for quality improvement: unintended extubation, surgical technical failures, missed injuries, and catheter-related issues.
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