• Rodolpho Augusto de Moura Pedro, BesenBruno Adler Maccagnan PinheiroBAMPIntensive Care Unit, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil., Pedro Vitale Mendes, Augusto Cezar Marins Gomes, Marcelo Ticianelli de Carvalho, MalbouissonLuiz Marcelo SáLMSIntensive Care Unit, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil., Marcelo Park, and Leandro Utino Taniguchi.
• Intensive Care Unit, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil. Electronic address: rodolphopedro@hc.fm.usp.br.
• J Crit Care. 2023 Dec 26; 80: 154510154510.

IntroductionAdverse events (AE) are frequent in critical care and could be even more prevalent in LMIC due to a shortage of ICU beds and Human resources. There is limited data on how relevant AE are among the reasons for ICU admission, being all of which published by High-Income-Countries services. Our main goal is to describe the rate of adverse events-related ICU admissions and their preventability in a LMIC scenario, comparing our results with previous data.MethodsThis was a prospective cohort study, during a one-year period, in two general ICUs from a tertiary public academic hospital. Our exposure of interest was ICU admission related to an AE in adult patients, we further characterized their preventability and clinical outcomes. We also performed a systematic review to identify and compare previous published data on ICU admissions due to AE.ResultsAmong all ICU admissions, 12.1% were related to an AE (9.8% caused by an AE, 2.3% related but not directly caused by an AE). These ICU admissions were not associated with a higher risk of death, but most of them were potentially preventable (70.9% of preventability rate, representing 8.6% of all ICU admissions). The meta-analysis resulted in a proportion of ICU admissions due to AE of 11% (95% CI 6%-16%), with a preventability rate of 54% (95% CI 42%-66%).ConclusionsIn this prospective cohort, adverse events were a relevant reason for ICU admission. This result is consistent with data retrieved from non-LMIC as shown in our meta-analysis. The high preventability rate described reinforces that quality and safety programs could work as a tool to optimize scarce resources.Copyright © 2023. Published by Elsevier Inc.

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