What clinical and organizational risk factors, according to the English-language literature, are associated with complications in rheumatology patients? A risk management study
Keywords:
clinical risk, organizational risk, English literature, complications, patient safety, risk management, rheumatologyAbstract
Introduction: the lack of local evidence, integrated with available global knowledge, limits the ability of healthcare teams and institutional managers to systematically identify the most relevant risk factors. Consequently, a knowledge gap exists that hinders the optimal translation of Anglo-Saxon evidence on clinical and organizational risk factors into strategies for improving patient safety.
Objective: To determine the clinical and organizational risk factors associated with the development of complications in adult patients with rheumatological diseases, considering variables widely described and supported by Anglo-Saxon scientific literature, from a clinical and organizational risk management perspective.
Methods: procedure for identifying and operationalizing clinical and organizational variables was developed through a review of Anglo-Saxon scientific literature published in international databases. Subsequently, an analytical observational case-control study was conducted using multivariate logistic regression models, survival analysis, and interaction analysis between variables, with the aim of generating useful evidence for risk management and improving patient safety.
Results: all patients in the sample were included in the multivariate logistic regression analysis. After model adjustment, age 60 years or older maintained a statistically significant association with the occurrence of risks, demonstrating a higher risk of complications in older patients. Among the clinical factors, the time elapsed from symptom onset to diagnosis greater than six months was significantly associated with the presence of complications, doubling the risk of adverse events (OR = 2.284).
Conclusions: advanced age, delayed diagnosis, and late initiation of treatment are identified as priority clinical risk factors, as they compromise critical stages of the care process that, according to international evidence, constitute fundamental control points for the prevention of adverse events.
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