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Analysis of central venous access injuries from claims to the Swedish Patient Insurance Company 2009-2017

Lindgren, Sophie ; Gustafson, Pelle LU and Hammarskjöld, Fredrik (2019) In Acta Anaesthesiologica Scandinavica 63(10). p.1378-1383
Abstract

INTRODUCTION: Insertion and use of central venous access devices (CVADs) can be associated with serious adverse events. The incidence is generally low but considering the vast use of CVADs the consequences can, from a patient safety and health economics perspective, be severe. No exact knowledge exists of number of catheters or complications in Sweden, as there is currently no comprehensive registry. The aim was to analyse injuries reported to the Swedish National Patient Insurance Company (Löf) within 7 days after insertion or removal of a CVAD.

METHODS: A retrospective analysis of all injuries filed in the period 2009-2017 was performed, evaluating patient data, type of catheter, insertion technique and type of injury. If the... (More)

INTRODUCTION: Insertion and use of central venous access devices (CVADs) can be associated with serious adverse events. The incidence is generally low but considering the vast use of CVADs the consequences can, from a patient safety and health economics perspective, be severe. No exact knowledge exists of number of catheters or complications in Sweden, as there is currently no comprehensive registry. The aim was to analyse injuries reported to the Swedish National Patient Insurance Company (Löf) within 7 days after insertion or removal of a CVAD.

METHODS: A retrospective analysis of all injuries filed in the period 2009-2017 was performed, evaluating patient data, type of catheter, insertion technique and type of injury. If the injury was deemed avoidable by Löf, degree of disability and mortality was registered.

RESULTS: A total of 87 claims of injuries were found of which 36 (41%) were assessed as avoidable. The most common injuries were: bleeding (18%), early infection (17%), pneumothorax (17%) and early thrombosis (15%). No patients died of their injuries, but 17 of 36 suffered permanent disability of varying degrees. Ultrasound-guided insertion was used in 19% of the cases.

CONCLUSION: In Sweden, few injuries related to CVAD use are reported to Löf. About 40% of filed claims were categorized as having an avoidable injury and therefore eligible for compensation. About half of the compensated patients suffered a permanent disability. The results indicate underreporting of CVC-related injuries in Sweden during the studied time-period.

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Please use this url to cite or link to this publication:
author
; and
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Catheterization, Central Venous/adverse effects, Female, Humans, Insurance Claim Reporting/statistics & numerical data, Male, Middle Aged, Retrospective Studies, Sweden
in
Acta Anaesthesiologica Scandinavica
volume
63
issue
10
pages
6 pages
publisher
Wiley-Blackwell
external identifiers
  • scopus:85069837751
  • pmid:31313279
ISSN
0001-5172
DOI
10.1111/aas.13430
language
English
LU publication?
no
additional info
© 2019 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
id
3fea52ff-efdc-42e4-9570-ec95011d80e4
date added to LUP
2020-11-21 16:54:58
date last changed
2024-03-05 15:14:11
@article{3fea52ff-efdc-42e4-9570-ec95011d80e4,
  abstract     = {{<p>INTRODUCTION: Insertion and use of central venous access devices (CVADs) can be associated with serious adverse events. The incidence is generally low but considering the vast use of CVADs the consequences can, from a patient safety and health economics perspective, be severe. No exact knowledge exists of number of catheters or complications in Sweden, as there is currently no comprehensive registry. The aim was to analyse injuries reported to the Swedish National Patient Insurance Company (Löf) within 7 days after insertion or removal of a CVAD.</p><p>METHODS: A retrospective analysis of all injuries filed in the period 2009-2017 was performed, evaluating patient data, type of catheter, insertion technique and type of injury. If the injury was deemed avoidable by Löf, degree of disability and mortality was registered.</p><p>RESULTS: A total of 87 claims of injuries were found of which 36 (41%) were assessed as avoidable. The most common injuries were: bleeding (18%), early infection (17%), pneumothorax (17%) and early thrombosis (15%). No patients died of their injuries, but 17 of 36 suffered permanent disability of varying degrees. Ultrasound-guided insertion was used in 19% of the cases.</p><p>CONCLUSION: In Sweden, few injuries related to CVAD use are reported to Löf. About 40% of filed claims were categorized as having an avoidable injury and therefore eligible for compensation. About half of the compensated patients suffered a permanent disability. The results indicate underreporting of CVC-related injuries in Sweden during the studied time-period.</p>}},
  author       = {{Lindgren, Sophie and Gustafson, Pelle and Hammarskjöld, Fredrik}},
  issn         = {{0001-5172}},
  keywords     = {{Catheterization, Central Venous/adverse effects; Female; Humans; Insurance Claim Reporting/statistics & numerical data; Male; Middle Aged; Retrospective Studies; Sweden}},
  language     = {{eng}},
  number       = {{10}},
  pages        = {{1378--1383}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Acta Anaesthesiologica Scandinavica}},
  title        = {{Analysis of central venous access injuries from claims to the Swedish Patient Insurance Company 2009-2017}},
  url          = {{http://dx.doi.org/10.1111/aas.13430}},
  doi          = {{10.1111/aas.13430}},
  volume       = {{63}},
  year         = {{2019}},
}