LymphedemaV1, Main, Exploration, bibRecord, 000B92

ReCAP: Detection of Potentially Avoidable Harm in Oncology From Patient Medical Records

Identifieur interne : 000B92 ( Main/Exploration ); précédent : 000B91; suivant : 000B93

ReCAP: Detection of Potentially Avoidable Harm in Oncology From Patient Medical Records

Auteurs : Allison Lipitz-Snyderman [États-Unis] ; Saul N. Weingart [États-Unis] ; Christopher Anderson [États-Unis] ; Andrew S. Epstein [États-Unis] ; Aileen Killen [États-Unis] ; David Classen [États-Unis] ; Camelia S. Sima [États-Unis] ; Elizabeth Fortier [États-Unis] ; Coral L. Atoria [États-Unis] ; David Pfister [États-Unis]

Source :

Journal of Oncology Practice [ 1554-7477 ] ; 2016.

RBID : PMC:5486447

Abstract

QUESTION ASKED:

Although medical record–based measurement of adverse events (AEs) associated with cancer care is desirable, condition-specific triggers in oncology care are needed. We sought to develop a screening tool to facilitate efficient detection of AEs across settings of cancer care via medical record review. We hope to use this tool to understand the frequency, spectrum, and preventability of AEs with the goal of helping improve the quality and safety of cancer care.

SUMMARY ANSWER:

We developed a cancer-specific screening tool to help identify candidate preventable AEs that occur during cancer care from patients’ medical records. Our oncology screening tool consists of 76 triggers—readily identifiable findings to screen for possible AEs that occur during cancer care (Table 1).

METHODS:

We sought to develop a screening tool to facilitate the detection of AEs across settings of cancer care via medical record review. We obtained structured and unstructured input from clinical experts to develop our tool, using a modified Delphi process.

BIAS, CONFOUNDING FACTOR(S), DRAWBACKS:

Our oncology tool requires further evaluation in order to understand its usefulness for population-based assessments of AEs in oncology and quality improvement.

REAL-LIFE IMPLICATIONS:

Information obtained from structured record reviews using an oncology trigger tool could help to prioritize quality improvement activities, identify high-risk groups, and generate cancer-focused quality measures. Ultimately, the goals of this work are to prevent AEs and allow timely, automated identification of these events so that clinicians can intervene promptly to improve patient outcomes.

Table 1.

Memorial Sloan Kettering Cancer Center Oncology Trigger Tool

	Trigger
Laboratory
L1	Adrenal function studies*
L2	Abnormal phosphate (> 5, < 1.5 mg/dL)*
L3	Abnormal serum bicarbonate (< 18, > 36 mEq/L)*
L4	Abnormal serum bilirubin (> 2 mg/dL)*
L5	Abnormal serum calcium (> 12, < 7 mg/dL)*
L6	Abnormal serum magnesium (> 4, < 1.5 mg/dL)*
L7	Abnormal serum potassium (> 6, < 2.5 mEq/L)*
L8	Abnormal serum sodium (> 150, < 130 mEq/L)*
L9	Arterial blood gas (not in PACU/ICU)*
L10	Bladder catheter and positive urine culture*
L11	BNP (> 400 pg/mL)*
L12	Clostridium difficile toxin positive*
L13	Elevated AST (> 300 units/L) or ALT (> 300 units/L)*
L14	Elevated blood glucose (> 250 mg/dL)*
L15	Elevated creatinine > 1 mg/dL and 50% greater than baseline*
L16	Elevated INR (> 8)*
L17	Elevated lipase (> 160 U/L)*
L18	Elevated serum uric acid (> 10 mg/dL)*
L19	Elevated troponin (> 0.64 ng/mL)*
L20	Elevated TSH (> 10 mcU/mL)*
L21	Low fibrinogen (< 100 mg/dL)*
L22	Neutropenic fever (except in patients with leukemia or bone marrow transplant)*
L23	Platelet count < 20,000 (except in patients with leukemia or bone marrow transplant)*
L24	Positive blood culture without contaminant (eg, Staphylococcus epidermidis)*
L25	Tylenol blood level*
Orders
R1	Acute inpatient dialysis
R2	Blood transfusion
R3	Cardiac defibrillator
R4	Chest x-ray in inpatient or urgent care center
R5	Contact precautions/order for isolation
R6	Fistulogram/sinogram
R7	High-dose intravenous proton pump inhibitor (omeprazole, esomeprazole, and pantoprazole 80-mg bolus followed by 8 mg/h infusion)
R8	ICU transfer from floor
R9	Nasogastric tube (not in operating room)
R10	Noncontrast chest CT scan after radiation to the chest
R11	Percutaneous drain placement
R12	Platelet transfusion (except in patients with leukemia or bone marrow transplant)
R13	Positive bone imaging test (plain films, CT scans)
R14	Positive lower-extremity ultrasound
R15	Positive upper-extremity ultrasound
R16	Rapid response team
R17	Reintubation
R18	Steroid enema
R19	Use of pressors
Consultations
C1	Inpatient cardiology consult*
C2	Inpatient gastroenterology consult*
C3	Inpatient or outpatient IR consult (excluding referral for port placement)
C4	Inpatient surgery consult for nonsurgical patients*
C5	Lymphedema consult*
C6	Nephrology consult*
C7	Neurology consult and noncontrast head CT scan*
C8	Sitter and inpatient psychiatric consult*
General care
G1	Death in hospital
G2	Extravasation
G3	Fall
G4	Hospital readmission/urgent care visit within 72 h of hospital discharge or ambulatory surgery
G5	Low urine output (< 30 mL/h)
G6	Pressure ulcer
G7	Return to the operating room or IR within 30 days of surgery
Vital signs
V1	Blood pressure (> 200/100 mmHg)
V2	Low oximetry results (Sao₂ < 88%)
V3	Pain score (≥ 7)
V4	Temperature (< 35°C perioperatively)
Medication related
M1	Epinephrine*
M2	Flumazenil, glucagon, naloxone, protamine*
M3	Initiation of therapeutic anticoagulation*
M4	Intravascular thrombolytic therapy*
M5	Kayexalate*
M6	Methylnaltrexone*
M7	Octreotide*
M8	Oral anesthetics (eg, Magic Mouthwash, viscous lidocaine)*
M9	Sodium thiosulfate, hyaluronidase, topical dimethylsulfoxide, dexrazoxane, phentolamine*
M10	Total parenteral nutrition*
M11	Use of intravenous glucose or dextrose*
M12	Use of more than three doses of antiemetics within 24 h*
M13	Vitamin K*

Abbreviations: BNP, brain natriuretic peptide; CT, computed tomography; ICU, intensive care unit; INR, international normalized ratio; IR, interventional radiology; PACU, postanesthesia care unit; Sao₂, arterial oxygen saturation; TSH, thyroid-stimulating hormone.

Triggers have been automated in the pilot study at Memorial Sloan Kettering Cancer Center.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5486447

DOI: 10.1200/JOP.2015.006874
PubMed: 26869656
PubMed Central: 5486447

Affiliations:

Le document en format XML

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<author><name sortKey="Sima, Camelia S" sort="Sima, Camelia S" uniqKey="Sima C" first="Camelia S." last="Sima">Camelia S. Sima</name>
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<author><name sortKey="Fortier, Elizabeth" sort="Fortier, Elizabeth" uniqKey="Fortier E" first="Elizabeth" last="Fortier">Elizabeth Fortier</name>
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</affiliation>
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<front><div type="abstract" xml:lang="en"><sec><title>QUESTION ASKED:</title>
<p>Although medical record–based measurement of adverse events (AEs) associated with cancer care is desirable, condition-specific triggers in oncology care are needed. We sought to develop a screening tool to facilitate efficient detection of AEs across settings of cancer care via medical record review. We hope to use this tool to understand the frequency, spectrum, and preventability of AEs with the goal of helping improve the quality and safety of cancer care.</p>
</sec>
<sec><title>SUMMARY ANSWER:</title>
<p>We developed a cancer-specific screening tool to help identify candidate preventable AEs that occur during cancer care from patients’ medical records. Our oncology screening tool consists of 76 triggers—readily identifiable findings to screen for possible AEs that occur during cancer care (<xref ref-type="table" rid="T01">Table 1</xref>
).</p>
</sec>
<sec><title>METHODS:</title>
<p>We sought to develop a screening tool to facilitate the detection of AEs across settings of cancer care via medical record review. We obtained structured and unstructured input from clinical experts to develop our tool, using a modified Delphi process.</p>
</sec>
<sec><title>BIAS, CONFOUNDING FACTOR(S), DRAWBACKS:</title>
<p>Our oncology tool requires further evaluation in order to understand its usefulness for population-based assessments of AEs in oncology and quality improvement.</p>
</sec>
<sec><title>REAL-LIFE IMPLICATIONS:</title>
<p>Information obtained from structured record reviews using an oncology trigger tool could help to prioritize quality improvement activities, identify high-risk groups, and generate cancer-focused quality measures. Ultimately, the goals of this work are to prevent AEs and allow timely, automated identification of these events so that clinicians can intervene promptly to improve patient outcomes.</p>
<table-wrap id="T01" position="float"><label>Table 1.</label>
<caption><p>Memorial Sloan Kettering Cancer Center Oncology Trigger Tool</p>
</caption>
<alternatives><graphic xlink:href="JOPR006874t01"></graphic>
<table frame="hsides" rules="groups"><col width="20.81%" span="1"></col>
<col width="79.19%" span="1"></col>
<thead><tr><th valign="top" align="left" scope="col" rowspan="1" colspan="1"></th>
<th valign="bottom" align="left" scope="col" rowspan="1" colspan="1">Trigger</th>
</tr>
</thead>
<tbody><tr><td valign="top" align="left" scope="col" rowspan="1" colspan="1">Laboratory</td>
<td valign="bottom" align="left" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> L1</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Adrenal function studies<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> L2</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Abnormal phosphate (> 5, < 1.5 mg/dL)<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> L3</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Abnormal serum bicarbonate (< 18, > 36 mEq/L)<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> L4</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Abnormal serum bilirubin (> 2 mg/dL)<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> L5</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Abnormal serum calcium (> 12, < 7 mg/dL)<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> L6</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Abnormal serum magnesium (> 4, < 1.5 mg/dL)<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> L7</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Abnormal serum potassium (> 6, < 2.5 mEq/L)<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> L8</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Abnormal serum sodium (> 150, < 130 mEq/L)<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> L9</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Arterial blood gas (not in PACU/ICU)<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> L10</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Bladder catheter and positive urine culture<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> L11</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">BNP (> 400 pg/mL)<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> L12</td>
<td valign="bottom" align="left" rowspan="1" colspan="1"><italic>Clostridium difficile</italic>
 toxin positive<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> L13</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Elevated AST (> 300 units/L) or ALT (> 300 units/L)<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> L14</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Elevated blood glucose (> 250 mg/dL)<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> L15</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Elevated creatinine > 1 mg/dL and 50% greater than baseline<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> L16</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Elevated INR (> 8)<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> L17</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Elevated lipase (> 160 U/L)<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> L18</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Elevated serum uric acid (> 10 mg/dL)<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> L19</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Elevated troponin (> 0.64 ng/mL)<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> L20</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Elevated TSH (> 10 mcU/mL)<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> L21</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Low fibrinogen (< 100 mg/dL)<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> L22</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Neutropenic fever (except in patients with leukemia or bone marrow transplant)<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> L23</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Platelet count < 20,000 (except in patients with leukemia or bone marrow transplant)<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> L24</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Positive blood culture without contaminant (eg, <italic>Staphylococcus epidermidis</italic>
)<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> L25</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Tylenol blood level<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="col" rowspan="1" colspan="1">Orders</td>
<td valign="bottom" align="left" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> R1</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Acute inpatient dialysis</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> R2</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Blood transfusion</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> R3</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Cardiac defibrillator</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> R4</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Chest x-ray in inpatient or urgent care center</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> R5</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Contact precautions/order for isolation</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> R6</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Fistulogram/sinogram</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> R7</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">High-dose intravenous proton pump inhibitor (omeprazole, esomeprazole, and pantoprazole 80-mg bolus followed by 8 mg/h infusion)</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> R8</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">ICU transfer from floor</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> R9</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Nasogastric tube (not in operating room)</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> R10</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Noncontrast chest CT scan after radiation to the chest</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> R11</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Percutaneous drain placement</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> R12</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Platelet transfusion (except in patients with leukemia or bone marrow transplant)</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> R13</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Positive bone imaging test (plain films, CT scans)</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> R14</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Positive lower-extremity ultrasound</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> R15</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Positive upper-extremity ultrasound</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> R16</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Rapid response team</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> R17</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Reintubation</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> R18</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Steroid enema</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> R19</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Use of pressors</td>
</tr>
<tr><td valign="top" align="left" scope="col" rowspan="1" colspan="1">Consultations</td>
<td valign="bottom" align="left" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> C1</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Inpatient cardiology consult<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> C2</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Inpatient gastroenterology consult<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> C3</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Inpatient or outpatient IR consult (excluding referral for port placement)</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> C4</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Inpatient surgery consult for nonsurgical patients<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> C5</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Lymphedema consult<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> C6</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Nephrology consult<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> C7</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Neurology consult and noncontrast head CT scan<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> C8</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Sitter and inpatient psychiatric consult<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="col" rowspan="1" colspan="1">General care</td>
<td valign="bottom" align="left" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> G1</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Death in hospital</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> G2</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Extravasation</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> G3</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Fall</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> G4</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Hospital readmission/urgent care visit within 72 h of hospital discharge or ambulatory surgery</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> G5</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Low urine output (< 30 mL/h)</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> G6</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Pressure ulcer</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> G7</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Return to the operating room or IR within 30 days of surgery</td>
</tr>
<tr><td valign="top" align="left" scope="col" rowspan="1" colspan="1">Vital signs</td>
<td valign="bottom" align="left" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> V1</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Blood pressure (> 200/100 mmHg)</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> V2</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Low oximetry results (Sa<sc>o</sc>
<sub>2</sub>
 < 88%)</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> V3</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Pain score (≥ 7)</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> V4</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Temperature (< 35°C perioperatively)</td>
</tr>
<tr><td valign="top" align="left" scope="col" rowspan="1" colspan="1">Medication related</td>
<td valign="bottom" align="left" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> M1</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Epinephrine<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> M2</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Flumazenil, glucagon, naloxone, protamine<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> M3</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Initiation of therapeutic anticoagulation<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> M4</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Intravascular thrombolytic therapy<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> M5</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Kayexalate<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> M6</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Methylnaltrexone<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> M7</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Octreotide<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> M8</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Oral anesthetics (eg, Magic Mouthwash, viscous lidocaine)<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> M9</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Sodium thiosulfate, hyaluronidase, topical dimethylsulfoxide, dexrazoxane, phentolamine<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> M10</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Total parenteral nutrition<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> M11</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Use of intravenous glucose or dextrose<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> M12</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Use of more than three doses of antiemetics within 24 h<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
<tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> M13</td>
<td valign="bottom" align="left" rowspan="1" colspan="1">Vitamin K<xref ref-type="table-fn" rid="t01n1">*</xref>
</td>
</tr>
</tbody>
</table>
</alternatives>
<table-wrap-foot><fn fn-type="abbr"><p>Abbreviations: BNP, brain natriuretic peptide; CT, computed tomography; ICU, intensive care unit; INR, international normalized ratio; IR, interventional radiology; PACU, postanesthesia care unit; Sa<sc>o</sc>
<sub>2</sub>
, arterial oxygen saturation; TSH, thyroid-stimulating hormone.</p>
</fn>
<fn id="t01n1"><label>*</label>
<p>Triggers have been automated in the pilot study at Memorial Sloan Kettering Cancer Center.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</sec>
</div>
</front>
</TEI>
<affiliations><list><country><li>États-Unis</li>
</country>
<region><li>Californie</li>
</region>
</list>
<tree><country name="États-Unis"><region name="Californie"><name sortKey="Lipitz Snyderman, Allison" sort="Lipitz Snyderman, Allison" uniqKey="Lipitz Snyderman A" first="Allison" last="Lipitz-Snyderman">Allison Lipitz-Snyderman</name>
</region>
<name sortKey="Anderson, Christopher" sort="Anderson, Christopher" uniqKey="Anderson C" first="Christopher" last="Anderson">Christopher Anderson</name>
<name sortKey="Atoria, Coral L" sort="Atoria, Coral L" uniqKey="Atoria C" first="Coral L." last="Atoria">Coral L. Atoria</name>
<name sortKey="Classen, David" sort="Classen, David" uniqKey="Classen D" first="David" last="Classen">David Classen</name>
<name sortKey="Epstein, Andrew S" sort="Epstein, Andrew S" uniqKey="Epstein A" first="Andrew S." last="Epstein">Andrew S. Epstein</name>
<name sortKey="Fortier, Elizabeth" sort="Fortier, Elizabeth" uniqKey="Fortier E" first="Elizabeth" last="Fortier">Elizabeth Fortier</name>
<name sortKey="Killen, Aileen" sort="Killen, Aileen" uniqKey="Killen A" first="Aileen" last="Killen">Aileen Killen</name>
<name sortKey="Pfister, David" sort="Pfister, David" uniqKey="Pfister D" first="David" last="Pfister">David Pfister</name>
<name sortKey="Sima, Camelia S" sort="Sima, Camelia S" uniqKey="Sima C" first="Camelia S." last="Sima">Camelia S. Sima</name>
<name sortKey="Weingart, Saul N" sort="Weingart, Saul N" uniqKey="Weingart S" first="Saul N." last="Weingart">Saul N. Weingart</name>
</country>
</tree>
</affiliations>
</record>

Pour manipuler ce document sous Unix (Dilib)

EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/LymphedemaV1/Data/Main/Exploration

HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000B92 | SxmlIndent | more

HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 000B92 | SxmlIndent | more

Pour mettre un lien sur cette page dans le réseau Wicri

{{Explor lien
   |wiki=    Wicri/Sante
   |area=    LymphedemaV1
   |flux=    Main
   |étape=   Exploration
   |type=    RBID
   |clé=     PMC:5486447
   |texte=   ReCAP: Detection of Potentially Avoidable Harm in Oncology From Patient Medical Records
}}

Pour générer des pages wiki

HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Exploration/RBID.i   -Sk "pubmed:26869656" \
       | HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd   \
       | NlmPubMed2Wicri -a LymphedemaV1

This area was generated with Dilib version V0.6.31.
Data generation: Sat Nov 4 17:40:35 2017. Site generation: Tue Feb 13 16:42:16 2024

Serveur d'exploration sur le lymphœdème

ReCAP: Detection of Potentially Avoidable Harm in Oncology From Patient Medical Records

ReCAP: Detection of Potentially Avoidable Harm in Oncology From Patient Medical Records

Source :

Abstract

Links toward previous steps (curation, corpus...)

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri

Pour générer des pages wiki

	Serveur d'exploration sur le lymphœdème
	Attention, ce site est en cours de développement ! Attention, site généré par des moyens informatiques à partir de corpus bruts. Les informations ne sont donc pas validées.