Question conne!!!!!
Modérateur : Marc
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Maxime
- Administrateur
- Messages : 6628
- Enregistré le : 06 avr. 2003, 11:09
- Année de diplôme IADE : 2004
- Poste occupé actuellement : Cadre IADE
- Localisation : Toulouse
- Contact :
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Louise Michel
Je relate un paragraphe d'une présentation qui citait une étude... forçement les chiffres sont discutables ; pour cela il faudrait lire l'étude dans sa langue d'origine (l'anglais).JulienL a écrit :on fait un concours de fautes d'orthographes, de langages incompréhensibles ? Non c'est pour blaguer, je m'excuse louise ... Est-il vraiment possible de documenter la mortalité péri-opératoire en fonction du personnel en poste ? A mon avis, ce débat est stérile et heureusement ... ? ???
Nous savons que l'on peut faire dire ce que l'on veut aux chiffres.
Il n'en demeure pas moins qu'en réponse à la question initiale, c'est la seule source documentée que l'on puisse trouver sur la plus-value des IADE en anésthésie.
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Louise Michel
Pour les fautes.... disons que c'est une série d'erreurs imputable à la charge de travail existante au moment de la rédaction du message.JulienL a écrit :on fait un concours de fautes d'orthographes, de langages incompréhensibles ? Non c'est pour blaguer, je m'excuse louise ... Est-il vraiment possible de documenter la mortalité péri-opératoire en fonction du personnel en poste ? A mon avis, ce débat est stérile et heureusement ... ? ???
Ca te va ?
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Louise Michel
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MrConick
- Donateur Laryngo 2011 2012
- Messages : 86
- Enregistré le : 12 juin 2007, 08:33
Pour ceux que ca intéressent, un petit résumé chiffré de cette étude.
Malheureusement c'est en anglais, et j'avoue ma flemme de faire la traduction (mais vous êtes tous bilingues, non ?)
Effectivement, on parle bien de facteurs minimisant le risque et des iades, mais les statistiques font appel aux "odds ratio" . Google sera votre ami, pour moi c'est un peu trop compliqué à expliquer :o)
Je ne sais pas d'ou vient la notion de 60% évoqué précedemment, c'était dans l'étude ? Parcque ca me semble énorme!
BACKGROUND: Quantitative estimates of how anesthesia management impacts perioperative morbidity and mortality are limited. The authors performed a study to identify risk factors related to anesthesia management for 24-h postoperative severe morbidity and mortality.
METHODS: A case-control study was performed of all patients undergoing anesthesia (1995-1997). Cases were patients who either remained comatose or died during or within 24 h of undergoing anesthesia. Controls were patients who neither remained comatose nor died during or within 24 hours of undergoing anesthesia. Data were collected by means of a questionnaire, the anesthesia and recovery form. Odds ratios were calculated for risk factors, adjusted for confounders.
RESULTS: The cohort comprised 869,483 patients; 807 cases and 883 controls were analyzed. The incidence of 24-h postoperative death was 8.8 (95% confidence interval, 8.2-9.5) per 10,000 anesthetics. The incidence of coma was 0.5 (95% confidence interval, 0.3-0.6). Anesthesia management factors that were statistically significantly associated with a decreased risk were:
equipment check with protocol and checklist (odds ratio, 0.64), documentation of the equipment check (odds ratio, 0.61),
a directly available anesthesiologist (odds ratio, 0.46),
no change of anesthesiologist during anesthesia (odds ratio, 0.44), presence of a full-time working anesthetic nurse (odds ratio, 0.41),
two persons present at emergence (odds ratio, 0.69),
reversal of anesthesia (for muscle relaxants and the combination of muscle relaxants and opiates; odds ratios, 0.10 and 0.29, respectively), and postoperative pain medication as opposed to no pain medication, particularly if administered epidurally or intramuscularly as opposed to intravenously.
CONCLUSIONS: Mortality after surgery is substantial and an association was established between perioperative coma and death and anesthesia management factors like intraoperative presence of anesthesia personnel, administration of drugs intraoperatively and postoperatively, and characteristics of delivered intraoperative and postoperative anesthetic
care [/b]
Malheureusement c'est en anglais, et j'avoue ma flemme de faire la traduction (mais vous êtes tous bilingues, non ?)
Effectivement, on parle bien de facteurs minimisant le risque et des iades, mais les statistiques font appel aux "odds ratio" . Google sera votre ami, pour moi c'est un peu trop compliqué à expliquer :o)
Je ne sais pas d'ou vient la notion de 60% évoqué précedemment, c'était dans l'étude ? Parcque ca me semble énorme!
BACKGROUND: Quantitative estimates of how anesthesia management impacts perioperative morbidity and mortality are limited. The authors performed a study to identify risk factors related to anesthesia management for 24-h postoperative severe morbidity and mortality.
METHODS: A case-control study was performed of all patients undergoing anesthesia (1995-1997). Cases were patients who either remained comatose or died during or within 24 h of undergoing anesthesia. Controls were patients who neither remained comatose nor died during or within 24 hours of undergoing anesthesia. Data were collected by means of a questionnaire, the anesthesia and recovery form. Odds ratios were calculated for risk factors, adjusted for confounders.
RESULTS: The cohort comprised 869,483 patients; 807 cases and 883 controls were analyzed. The incidence of 24-h postoperative death was 8.8 (95% confidence interval, 8.2-9.5) per 10,000 anesthetics. The incidence of coma was 0.5 (95% confidence interval, 0.3-0.6). Anesthesia management factors that were statistically significantly associated with a decreased risk were:
equipment check with protocol and checklist (odds ratio, 0.64), documentation of the equipment check (odds ratio, 0.61),
a directly available anesthesiologist (odds ratio, 0.46),
no change of anesthesiologist during anesthesia (odds ratio, 0.44), presence of a full-time working anesthetic nurse (odds ratio, 0.41),
two persons present at emergence (odds ratio, 0.69),
reversal of anesthesia (for muscle relaxants and the combination of muscle relaxants and opiates; odds ratios, 0.10 and 0.29, respectively), and postoperative pain medication as opposed to no pain medication, particularly if administered epidurally or intramuscularly as opposed to intravenously.
CONCLUSIONS: Mortality after surgery is substantial and an association was established between perioperative coma and death and anesthesia management factors like intraoperative presence of anesthesia personnel, administration of drugs intraoperatively and postoperatively, and characteristics of delivered intraoperative and postoperative anesthetic
care [/b]