The scientific methodology to prevent a perioperative incident by detecting the risk factors and assessing the intervention
| Project/Area Number |
17K18121
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| Research Category |
Grant-in-Aid for Young Scientists (B)
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| Allocation Type | Multi-year Fund |
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| Research Field |
Anesthesiology
Medical and hospital managemen
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| Research Institution | Teikyo University |
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Principal Investigator |
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| Project Period (FY) |
2017-04-01 – 2020-03-31
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| Project Status |
Completed (Fiscal Year 2019)
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| Budget Amount *help |
¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000)
Fiscal Year 2018: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2017: ¥2,730,000 (Direct Cost: ¥2,100,000、Indirect Cost: ¥630,000)
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| Keywords | 術後チューブ抜去 / 術後せん妄 / 医療事故 / 周術期管理学 / リスクマネジメント / 医療事故予防 / 医療安全 |
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| Outline of Final Research Achievements |
We conducted the case-control study to detect the risk factors, which compared self-extubation group with control group by the type of tube and department, using the past 5 year incident report data. As a result, the preoperative risk factors of the postoperative self-extubation were the major abdominal operation, the history of dementia, and the history of stroke.
We compared the incidence of POCD between sevoflurane and propofol. The study patients were over 60 year old patients scheduled with total knee joint replacement. The primary outcome were the incidence of POCD at postoperative day 7, 3 month, and 12 month. As a result, the sevoflurane group showed significantly deep anesthetic level, but the incidence of POCD was not significantly different.
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| Academic Significance and Societal Importance of the Research Achievements |
本特究の大きなテーマである医療事故低減のためには、①事故の種類ごとにリスク因子を科学的に探索同定し、②ハイリスク因子の検証を行い、③ハイリスク群への対策を立案検証する、エビデンスに基づき実証された対策をガイドライン化することが重要である。さらに医療事故調査制度の下、最終的に全国に普及させることが必要と考える。具体的研究結果としては、術中麻酔管理による術後認知機能への影響が認めらないことが明らかになり、術後チューブ自己抜去のハイリスク患者において、全身麻酔薬を選択する上での術後認知機能障害への懸念が無くなった。
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Report
(4 results)
Research Products
(4 results)
