title: Prevalence of Aneurysmal Subarachnoid Hemorrhage Safety Indicators and Their Relation with Health Care Outcomes in a Mexican Population.
abstract: BACKGROUND
  Aneurysmal subarachnoid hemorrhage (ASAH) is a serious and unstable condition. Patient safety indicators (PSI) are a group of potentially preventable events in patient health care. The aim of this study is to determine the prevalence of 8 relevant PSI in a group of patients with ASAH and their relation with 2 health care outcomes.
  
  
  METHODS
  We performed a retrospective review of all patients admitted with ASAH. A total of 35 patients were selected with the following variables: age, sex, Hunt and Hess scale at admission, brain aneurysm treatment, length of hospital stay, and Glasgow Outcome Scale (GOS) score with the presence or absence of all 8 PSI: decubitus ulcer, pneumothorax, bacteremia, perioperative hematoma, postoperative respiratory failure, deep vein thrombosis (DVT), pulmonary thromboembolism, and accidental puncture or laceration.
  
  
  RESULTS
  Average age (±standard deviation) was 53 ± 13.9 years, with a female predominance of 63%. The most common PSI was decubitus ulcer followed by central line-related bacteremia. Prolonged hospital stay was increased for inpatients with DVT. Males had a risk effect (odds ratio, 6.25) in relation to the appearance of pulmonary thromboembolism as well as a poor neurologic condition according to the GOS (GOS score <4) related to the appearance of DVT (odds ratio, 8.0).
  
  
  CONCLUSIONS
  In our study population, we found 3 PSI related to a poor outcome measured with the GOS or to a longer hospital stay: decubitus ulcer, central line-related bacteremia, and DVT. PSI have been academically considered as useful tools in clinical, epidemiologic, and research outcome scenarios. An adequate prevention protocol for these indicators could produce better outcomes in medical care for patients with ASAH.
authors.affiliation: Department of Neurosurgery, ABC Medical Center, Mexico City, Mexico. Electronic address: frevilla@neurociencias.net.
authors.forename: Francisco
authors.initials: F
authors.lastname: Revilla-Pacheco
authors.affiliation: Departamento de Instrumentacion Electromagnetica, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico.
authors.forename: Claudia
authors.initials: C
authors.lastname: Lerma
authors.affiliation: Department of Neurosurgery, ABC Medical Center, Mexico City, Mexico.
authors.forename: Juvenal
authors.initials: J
authors.lastname: Franco-Granillo
authors.affiliation: Department of Neurosurgery, ABC Medical Center, Mexico City, Mexico.
authors.forename: Salvador
authors.initials: S
authors.lastname: Manrique-Guzman
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D002532:Intracranial Aneurysm / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D015995:Prevalence; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000453:epidemiology* / Q000628:therapy
keywords: Glasgow Outcome Scale; Intracranial aneurysm; Patient safety indicator; Subarachnoid hemorrhage