title: Overview of adverse events related to invasive procedures in the intensive care unit.
abstract: BACKGROUND
  This study was conducted to determine the frequency, predictors, and clinical impact of adverse events (AEs) related to invasive procedures in the intensive care unit (ICU).
  
  
  METHODS
  This was a prospective observational study of ICUs in a university hospital.
  
  
  RESULTS
  A total of 893 patients requiring invasive procedures were admitted over a 1-year period. Among these, 310 patients (34.7%) experienced a total of 505 AEs. The mean number of AEs per patient was 1.6 ± 1.1 (range, 1-7). Infectious AEs were significantly more frequent than mechanical AEs (60.4% vs 39.6%; P = .01). Factors independently associated with AE occurrence were isolation of multidrug-resistant bacteria at ICU admission, >5 invasive procedures, and ICU length of stay >8 days. Thirty-three AEs (6.5%) resulted in severe clinical impact, including 24 deaths. Ventilator-associated pneumonia (VAP) accounted for 62.5% of the deaths related to AEs.
  
  
  CONCLUSIONS
  One-third of critically ill patients experienced AEs related to invasive procedures. Severe AEs were associated with 11% of all ICU deaths. VAP was the most frequent AE related to death. An improved assessment of the risk-benefit balance before each invasive procedure and increased efforts to decrease VAP prevalence are needed to reduce AE-related mortality.
authors.affiliation: Department of Anesthesia and Surgical Intensive Care, Caen University Hospital, France. pottier-v@chu-caen.fr
authors.forename: Véronique
authors.initials: V
authors.lastname: Pottier
authors.forename: Cédric
authors.initials: C
authors.lastname: Daubin
authors.forename: Nicolas
authors.initials: N
authors.lastname: Lerolle
authors.forename: Cathy
authors.initials: C
authors.lastname: Gaillard
authors.forename: Gérald
authors.initials: G
authors.lastname: Viquesnel
authors.forename: Benoit
authors.initials: B
authors.lastname: Plaud
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Hanouz
authors.forename: Pierre
authors.initials: P
authors.lastname: Charbonneau
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care / Q000379:methods*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology*; D015994:Incidence; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D012307:Risk Factors