Adverse events associated with care (AEAS) in superficial and deep vein surgery in France: analysis based on the HAS REX database.

Adverse Event Associated with Care (AEAC) in superficial and deep vein surgery in France: analysis from the HAS REX database.

Introduction: Superficial and deep venous surgery represents a major part of daily vascular activity. It is considered to be peu morbid. This study presents an analysis of the causes and consequences of AEIAS in venous surgery, collated in the HAS REX database, based on reports retained by the Vascurisq AO. Its secondary objective is to define patient safety recommendations specific to this activity. Method: The AEAC extracted from 2016 to 2023 were divided into 6 periods of occurrence and their causes classified into 5 categories: material defect, information transmission defect, technical error, pharmacological error or error related to the patient’s condition. Information failures were analysed in subgroups, and a pair of experts assessed whether there were any medical consequences, repercussions for the patient or financial impact. Results: 81 AEAC were analysed. 75.3% of them were considered to be avoidable. Faulty transmission of information accounted for the majority of AEAC (69.1%), 75% of which were due to a lack of communication within the healthcare chain. 23.5% of material defects, 22.2% of patient-related errors, 12.3% of technical errors and 11.1% of pharmacological errors were recorded. 65.4% of AEAC occurred on the day of the incident, including 32.1% intraoperatively and 24.7% before incision. 85.2% of respondents considered that the AEAC was responsible for a consequence. They were financial in 69.1% of cases, and responsible for a delay in treatment in 37%.They were considered not very serious in 40.7% of cases. 14.8% of complications (10 cases) required conversion or repeat surgery. Analysis of the REX database has led to the recommendation of a «programming checklist» specific to venous surgery for our discipline (see attached file). Conclusion: Patient safety is a constant concern throughout the course of care, both for the surgeon and for the authorities. Certain barriers, recommended by the HAS, make it possible to limit AEAC (e.g. the SPBO checklist, the 15 key points of surgeon-anaesthetist communication, etc.). The introduction of a specific programming checklist for venous surgery would make it possible to reduce the risks and consequences for both the patient and the surgeon.