Les évènements iatrogènes en réanimation : incidence, facteurs de risques et impacts sur la morbi-mortalité

The aims of this study were to establish the types and the risk factors of iatrogenic events (IE) in intensive care and their impact on outcomes of patients. All patients hospitalized more than 24 hours in the intensive care unit of the Tertiary hospital of Mahdia between 20th June 2011 and 19th June 2012 were included. Collected parameters were: demographic characteristics, severity score (IGS II), the reason for hospitalization in the ICU, iatrogenic events associated with drugs, procedures, and care, the Omega score, duration of mechanical ventilation and length of stay, and mortality. One hundred and eighty-six patients (mean age 57 ± 21 years, mean IGS II: 33 ± 20) were included in this study. The incidence of IE was 62.4% with an incidence density of 59 for 1000 days-patients. The incidences of iatrogenic events associated with drugs, procedures and of care were 34%, 43.5% and 24%, respectively. An Omega score greater than 25 was the only factor associated with the occurrence of IE (OR: 4.38, CI: 95% [1.995-9.638]). In 56% of cases, IE was avoidable. The mean duration of mechanical ventilation and length of stay in the ICU was increased by 10 days in case of IE. The mortality was significantly higher in the group with IE (34% vs 14%, P = 0.003). An IGS II > 25 and bedsores were the two independent factors associated with mortality. IE are frequent in ICU. They are avoidable in more than fifty percent and increase the morbi-mortality.