PMID- 30064956
OWN - NLM
STAT- MEDLINE
DCOM- 20191206
LR  - 20191217
IS  - 1553-7250 (Print)
IS  - 1553-7250 (Linking)
VI  - 44
IP  - 11
DP  - 2018 Nov
TI  - Characteristics of Reported Adverse Events During Moderate Procedural Sedation: 
      An Update.
PG  - 651-662
LID - S1553-7250(17)30475-0 [pii]
LID - 10.1016/j.jcjq.2018.03.011 [doi]
AB  - BACKGROUND: Many interventional procedures are performed under moderate 
      procedural sedation (MPS). It is important to understand the nature of and 
      factors contributing to adverse events (AEs). Little data exist examining 
      reportable AEs during MPS across specialties. A study was conducted to 
      investigate adverse events during MPS and to compare associated patient and 
      provider characteristics. METHODS: In a retrospective review, 83 MPS cases in 
      which safety incidents were reported (out of approximately 20,000 annual cases 
      during a 12-year period at a tertiary medical center) were analyzed. The type of 
      AE and severity of harm were examined using bivariate and multivariate analyses 
      to uncover associations between events with provider, procedure, and patient 
      characteristics. RESULTS: The most common AEs were oversedation/apnea (60.2%), 
      hypoxemia (42.2%), and aspiration (24.1%). The most common unplanned 
      interventions were the use of reversal agents (55.4%) and prolonged bag-mask 
      ventilation (25.3%). Cardiology, gastroenterology, and radiology were the 
      specialties most frequently associated with AEs. Reversal agents, oversedation, 
      and hypoxemia occurred most frequently in the gastroenterology and cardiology 
      suites. Women were more likely to experience AEs than men, incurring higher rates 
      of hypotension, prolonged bag-mask ventilation, and reversal agents. Increased 
      body mass index was associated with lower rates of hypoxemia, while advanced age 
      correlated with high rates of oversedation, harm done, and use of reversal 
      agents. Malignancy and cardiovascular comorbidities were associated with 
      increased AEs. Patients with respiratory comorbidities were less likely to be 
      subject to AEs. CONCLUSION: Certain patient characteristics and types of 
      procedures may be associated with increased risk of AEs during MPS.
CI  - Copyright (c) 2018 The Joint Commission. Published by Elsevier Inc. All rights 
      reserved.
FAU - Jones, Mark R
AU  - Jones MR
FAU - Karamnov, Sergey
AU  - Karamnov S
FAU - Urman, Richard D
AU  - Urman RD
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180727
PL  - Netherlands
TA  - Jt Comm J Qual Patient Saf
JT  - Joint Commission journal on quality and patient safety
JID - 101238023
SB  - IM
MH  - APACHE
MH  - Academic Medical Centers/statistics & numerical data
MH  - Adolescent
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Body Mass Index
MH  - Comorbidity
MH  - Conscious Sedation/*adverse effects
MH  - Female
MH  - Humans
MH  - Male
MH  - Medical Errors/*statistics & numerical data
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Sex Factors
MH  - Specialization/*statistics & numerical data
MH  - Young Adult
EDAT- 2018/08/02 06:00
MHDA- 2019/12/18 06:00
CRDT- 2018/08/02 06:00
PHST- 2017/10/02 00:00 [received]
PHST- 2018/03/16 00:00 [accepted]
PHST- 2018/08/02 06:00 [pubmed]
PHST- 2019/12/18 06:00 [medline]
PHST- 2018/08/02 06:00 [entrez]
AID - S1553-7250(17)30475-0 [pii]
AID - 10.1016/j.jcjq.2018.03.011 [doi]
PST - ppublish
SO  - Jt Comm J Qual Patient Saf. 2018 Nov;44(11):651-662. doi: 
      10.1016/j.jcjq.2018.03.011. Epub 2018 Jul 27.