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Only 8% of major preventable adverse events after hip arthroplasty are filed as claims: a Swedish multi-center cohort study on 1,998 patients.

只有 8% 的髋关节置换术后主要可预防的不良事件作为索赔提出: 一项针对 1,998 例患者的瑞典多中心队列研究。

  • 影响因子:3.18
  • DOI:10.1080/17453674.2019.1677382
  • 作者列表:"Magnéli M","Unbeck M","Samuelsson B","Rogmark C","Rolfson O","Gordon M","Sköldenberg O
  • 发表时间:2020-02-01
Abstract

:Background and purpose - Hip arthroplasty is one of the most performed surgeries in Sweden, and the rate of adverse events (AEs) is fairly high. All patients in publicly financed healthcare in Sweden are insured by the Mutual Insurance Company of Swedish County Councils (Löf). We assessed the proportion of patients that sustained a major preventable AE and filed an AE claim to Löf.Patients and methods - We performed retrospective record review using the Global Trigger Tool to identify AEs in a Swedish multi-center cohort consisting of 1,998 patients with a total or hemi hip arthroplasty. We compared the major preventable AEs with all patient-reported claims to Löf from the same cohort and calculated the proportion of filed claims.Results - We found 1,066 major preventable AEs in 744 patients. Löf received 62 claims for these AEs, resulting in a claim proportion of 8%. 58 of the 62 claims were accepted by Löf and received compensation. The claim proportion was 13% for the elective patients and 0.3% for the acute patients. The most common AE for filing a claim was periprosthetic joint infection; of the 150 infections found 37 were claimed.Interpretation - The proportion of filed claims for major preventable AEs is very low, even for obvious and serious AEs such as periprosthetic joint infection.

摘要

背景和目的: 髋关节置换术是瑞典实施最多的手术之一,不良事件 (AEs) 发生率相当高。瑞典公共资助医疗保健的所有患者都由瑞典县议会相互保险公司 (l ö f) 投保。我们评估了持续存在主要可预防AE的患者比例,并向l ö f提交了AE索赔。患者和方法-我们使用全球触发工具进行了回顾性记录审查,以确定由 1,998 例全髋关节置换术或半髋关节置换术患者组成的瑞典多中心队列中的AEs。我们将主要的可预防ae与来自同一队列的所有患者报告的对l ö f的索赔进行了比较,并计算了提交索赔的比例。结果-我们在 1,066 例患者中发现了 744 例主要的可预防ae。L ö f收到了 62 项关于这些ae的索赔,索赔比例为 8%。62 项索赔中有 58 项被l ö f接受并获得赔偿。择期患者的索赔比例为 13%,急性患者为 0.3%。提出索赔的最常见AE是假体周围关节感染; 在发现的 150 例感染中,有 37 例提出索赔。释义-主要可预防的ae的提交索赔比例很低,即使对于假体周围关节感染等明显和严重的ae也是如此。

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作者列表:["Beltai A","Barnetche T","Daien C","Lukas C","Gaujoux-Viala C","Combe B","Morel J"]

METHODS:OBJECTIVE:Patients with immune-mediated inflammatory diseases such as rheumatoid arthritis or systemic lupus erythematosus are at increased risk of cardiovascular disease. However, the cardiovascular risk of patients with primary Sjögren's syndrome (SS) remains poorly studied. We aimed to investigate the association between primary SS and cardiovascular morbidity and mortality. METHODS:We performed a systematic review of articles in Medline and the Cochrane Library and recent abstracts from US and European meetings, searching for reports of randomized controlled studies of cardiovascular morbidity and cardiovascular mortality in primary SS. The relative risk (RR) values for cardiovascular morbidity and mortality associated with primary SS were collected and pooled in a meta-analysis with a random-effects model by using Review Manager (Cochrane collaboration). RESULTS:The literature search revealed 484 articles and abstracts of interest; 14 studies (67,124 patients with primary SS) were included in the meta-analysis. With primary SS versus control populations, the risk was significantly increased for coronary morbidity (RR 1.34 [95% confidence interval (95% CI) 1.06-1.38]; P = 0.01), cerebrovascular morbidity (RR 1.46 [95% CI 1.43-1.49]; P < 0.00001), heart failure rate (odds ratio 2.54 [95% CI 1.30-4.97]; P < 0.007), and thromboembolic morbidity (RR 1.78 [95% CI 1.41-2.25]; P < 0.00001), with no statistically significant increased risk of cardiovascular mortality (RR 1.48 [95% CI 0.77-2.85]; P = 0.24). CONCLUSION:This meta-analysis demonstrates that primary SS is associated with increased cardiovascular morbidity, which suggests that these patients should be screened for cardiovascular comorbidities and considered for preventive interventions, in a multidisciplinary approach with cardiologists.

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影响因子:4.13
发表时间:2020-01-01
DOI:10.1002/acr.23824
作者列表:["Chen SK","Liao KP","Liu J","Kim SC"]

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影响因子:4.13
发表时间:2020-01-01
DOI:10.1002/acr.23827
作者列表:["Lee RR","Rashid A","Thomson W","Cordingley L"]

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