@article{fdi:010080633,
  title = {{A} framework proposal for quality and safety measurement in gynecologic emergency care},
  author = {{F}auconnier, {A}. and {P}rovot, {J}. and {L}e {C}reff, {I}. and {B}oulkedid, {R}. and {V}endittelli, {F}. and {D}oret-{D}ion, {M}. and {S}roussi, {J}. and {G}iraudet, {G}. and {J}acobs, {R}. and {B}ourret, {A}. and {B}auville, {E}. and {C}arvalho, {S}. and {T}ourette, {C}. and {K}oskas, {M}. and {A}kladios, {C}. and {N}isolle, {M}. and {L}ejeune, {C}. and {H}uchon, {C}. and {A}lberti, {C}. and {D}umont, {A}lexandre and {B}ouvier-{C}olle, {M}. {H}.},
  editor = {},
  language = {{ENG}},
  abstract = {{OBJECTIVE}: {T}o define and assess the prevalence of potentially life-threatening gynecologic emergencies among women presenting for acute pelvic pain for the purpose of developing measures to audit quality of care in emergency departments. {METHODS}: {W}e conducted a mixed-methods multicenter study at gynecologic emergency departments in {F}rance and {B}elgium. {A} modified {D}elphi procedure was first conducted in 2014 among health care professionals to define relevant combinations of potentially life-threatening conditions and near misses in the field of gynecologic emergency care. {A} prospective case-cohort study in the spring of 2015 then assessed the prevalence of these potentially life-threatening emergencies and near misses among women of reproductive age presenting for acute pelvic pain. {W}omen in the case group were identified at 21 participating centers. {T}he control group consisted of a sample of women hospitalized for acute pelvic pain not caused by a potentially life-threatening condition and a 10% random sample of outpatients. {RESULTS}: {E}ight gynecologic emergencies and 17 criteria for near misses were identified using the {D}elphi procedure. {A}mong the 3,825 women who presented for acute pelvic pain, 130 (3%) were considered to have a potentially life-threatening condition. {T}he most common diagnoses were ectopic pregnancies with severe bleeding (n=54; 42%), complex pelvic inflammatory disease (n=30; 23%), adnexal torsion (n=20; 15%), hemorrhagic miscarriage (n=15; 12%), and severe appendicitis (n=6; 5%). {T}he control group comprised 225 hospitalized women and 381 outpatients. {D}iagnostic errors occurred more frequently among women with potentially life-threatening emergencies than among either hospitalized (odds ratio [{OR}] 1.7, 95% {CI} 1.1-2.7) or outpatient ({OR} 14.7, 95% {CI} 8.1-26.8) women in the control group. {O}f the women with potentially life-threatening conditions, 26 met near-miss criteria compared with six with not potentially life-threatening conditions ({OR} 25.6, 95% {CI} 10.9-70.7). {CONCLUSIONS}: {P}otentially life-threatening gynecologic emergencies are high-risk conditions that may serve as a useful framework to improve quality and safety in emergency care.},
  keywords = {},
  booktitle = {},
  journal = {{O}bstetrics and {G}ynecology},
  volume = {136},
  numero = {5},
  pages = {912--921},
  ISSN = {0029-7844},
  year = {2020},
  DOI = {10.1097/aog.0000000000004132},
  URL = {https://www.documentation.ird.fr/hor/fdi:010080633},
}