What makes hospitalized patients more vulnerable and increases their risk of experiencing an adverse event?
International Journal for Quality in Health CarePublished 6 September 2011Open access
Jesús María Aranaz Andrés, R. Limon, José Joaquín Mira, Carlos Aibar Remón, María Teresa Gea, Yolanda Agra
Citations59
SJR quartileQ2
SJR score0.85
SNIP1.11
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
The true risk resides in the number of exposures to potentially iatrogenic actions, rather than being intrinsic to age or the presence of certain comorbidities.
Abstract
OBJECTIVE: To analyze the relationship between the appearance of adverse events (AEs) and both patient comorbidities and the use of medical devices. DESIGN: Retrospective medical records review study. SETTING: Twenty-four Spanish public hospitals. PARTICIPANTS: Clinical records of 5624 discharged patients. MAIN OUTCOME MEASURE: Incidence of AEs. RESULTS: Patients aged >65 have 2.4 times the risk of experiencing an AE compared with those aged 7 days) were associated with developing an AE during hospitalization. There is a trend effect if we consider the number of comorbidities and the number of devices used. Thus, the risk of an AE in subjects who present no comorbidities was 3.2%, which rose to 9.9% in those with one intrinsic risk factor, 16.7% in those with two and 29.3% in those with three or more. Similarly, subjects without extrinsic risk factor experienced an AE in 4.4% of cases, which rose to 9.6% when there was one risk factor, to 13.4% when there were two and to 33.0% when there were three or more risk factors. The effect of some of these pathologies and that associated with age disappeared on adjusting in line with other variables. CONCLUSIONS: The true risk resides in the number of exposures to potentially iatrogenic actions, rather than being intrinsic to age or the presence of certain comorbidities.
Keywords
MedicineHealth Professions
New England Journal of MedicineIncidence of Adverse Events and Negligence in Hospitalized Patients
4,666 Citations1991Troyen A. Brennan, Lucian L. Leape +7 more
The incidence of adverse events, defined as injuries caused by medical management, and of the subgroup of such injuries that resulted from negligent or substandard care, in New York State in 1984 were estimated.
The Medical Journal of AustraliaThe Quality in Australian Health Care Study
2,397 Citations1995R. M. Wilson, W. B. Runciman +4 more
Canadian Medical Association JournalThe Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada
2,350 Citations2004G. Ross Baker
The overall incidence rate of AEs of 7.5% in this study suggests that, of the almost 2.5 million annual hospital admissions in Canada similar to the type studied, about 185 000 are associated with an AE and close to 70 000 of these are potentially preventable.
BMJAdverse events in British hospitals: preliminary retrospective record review
2,074 Citations2001Charles Vincent, Graham Neale +1 more
These results suggest that adverse events are a serious source of harm to patients and a large drain on NHS resources.
AnesthesiologyASA Physical Status Classifications
1,947 Citations1978William D. Owens, James A. Felts +1 more
The ASA Physical Status Classification is useful but suffers from a lack of scientific precision.
Medical CareIncidence and Types of Adverse Events and Negligent Care in Utah and Colorado
1,671 Citations2000Eric J. Thomas, David M. Studdert +7 more
The incidence and types of adverse events in Utah and Colorado in 1992 were similar to those in New York State in 1984 and improving systems of surgical care and drug delivery could substantially reduce the burden of iatrogenic injury.
SurgeryThe incidence and nature of surgical adverse events in Colorado and Utah in 1992
974 Citations1999Atul A. Gawande, Eric J. Thomas +2 more
A retrospective chart review of 15,000 randomly selected admissions to Colorado and Utah hospitals during 1992 provided direction for research to identify the causes of surgical adverse events and for targeted quality improvement efforts.
PubMedAdverse events in New Zealand public hospitals I: occurrence and impact.
491 Citations2002Peter Davis, Roy Lay-Yee +4 more
The study provides representative base parameters that can contribute to the wider understanding, and potential improvement, of patient safety and the quality of care in New Zealand public hospitals.
BMJIncidence and types of preventable adverse events in elderly patients: population based review of medical records
423 Citations2000Eric J. Thomas
Preventable adverse events were more common among elderly patients, probably because of the clinical complexity of their care rather than age based discrimination and should be targets for efforts to prevent errors.
Archives of SurgeryComplications in Surgical Patients
325 Citations2002Mark A. Healey
Despite mortality rates that compare favorably with national benchmarks, a prospective examination of surgical patients reveals complication rates that are 2 to 4 times higher than those identified in an Institute of Medicine report.
Annals of Internal MedicinePhysician Reporting Compared with Medical-Record Review to Identify Adverse Medical Events
318 Citations1993Anne O’Neil, Laura A. Petersen +4 more
This study compared physician reporting of adverse events by the housestaff on the medical service of a teaching hospital with a retrospective two-step screening of the medical record for adverse events followed by implicit physician judgment about identified events and compared the combined strategies with the quality-of-care data routinely collected by the hospital.
Journal of Epidemiology & Community HealthIncidence of adverse events related to health care in Spain: results of the Spanish National Study of Adverse Events
281 Citations2008Jesús María Aranaz Andrés, C Aibar-Remón +5 more
The incidence of patients with AE related to medical assistance in Spanish hospitals was relevant and similar to those found in the studies from Canada and New Zealand that had been conducted with comparable methodology, indicating the need for AEs to be considered a public health priority in Europe.
Annals of Internal MedicineThe Reliability of Medical Record Review for Estimating Adverse Event Rates
256 Citations2002Eric J. Thomas, Stuart R. Lipsitz +2 more
Details are reported on the reliability of physician judgments about adverse events and negligent adverse events in the study from which the IOM derived its estimate of 44 000 error-related deaths per year and the effects of varying criteria for reviewer confidence in and reviewer agreement about the presence of adverse events.
PEDIATRICSAdverse Events and Preventable Adverse Events in Children
219 Citations2005Donna Woods, Eric J. Thomas +3 more
Analysis of pediatric hospitalizations in the Colorado and Utah Medical Practice Study involved a retrospective, 2-level medical record review of a population-based, representative sample of all pediatric hospital discharges, suggesting that 60% of these events may be preventable.
Journal of Critical CareICU incident reporting systems
186 Citations2002Albert W. Wu, Peter J. Pronovost +1 more
A Web-based ICU Safety Reporting System (ICUSRS) is designed, to identify high-risk situations and working conditions, to help change systems, and reduce the risk for error.
PubMedAdverse events in New Zealand public hospitals II: preventability and clinical context.
183 Citations2003Peter Davis, Roy Lay-Yee +4 more
System errors featured prominently as an area for prevention, being associated with nearly half of all preventable in-hospital events, and have a major impact on patient outcomes and extended hospital stay.
The Joint Commission Journal on Quality and Patient SafetyA Trigger Tool to Identify Adverse Events in the Intensive Care Unit
164 Citations2006Roger K. Resar, John D. Rozich +2 more
The Trigger Tool technique was used to identify the rate of occurrence of adverse events in the intensive care unit (ICU), and a subset of ICUs described those events in detail.
BMJ Quality & SafetyFrench national survey of inpatient adverse events prospectively assessed with ward staff
153 Citations2007Philippe Michel, Jean Luc Quenon +3 more
Clinical risk management should prioritise empowerment of local staff, provision of favourable conditions within the organisation, and staff training based on simple tools appropriate for ward-level identification and analysis of adverse events, as adverse events occurred more commonly in vulnerable patients.
Annals of Internal MedicineIdentifying Adverse Events Caused by Medical Care: Degree of Physician Agreement in a Retrospective Chart Review
153 Citations1996A. Russell Localio, Susan L. Weaver +5 more
A large sample of physician reviews of medical records was used to estimate the degree of agreement on the cause of adverse patient outcomes and the implications of the results for quality assurance, performance assessment, and proposals for no-fault patient compensation are discussed.
Medical CareReliability and Validity of Judgments Concerning Adverse Events Suffered by Hospitalized Patients
148 Citations1989Troyen A. Brennan, R J Localio +1 more
It was found that a two-step review process of medical records can produce judgments about adverse events that are both reliable and valid, and cases classified as difficult to judge from causation were judged less reliable.
Developments in critical care medicine and anestesiologyASA — Physical Status Classification
135 Citations1988G. M. Woerlee
The most useful clinical information the anaesthetist can gather about a patient preoperatively is the preoperative physical functional level, that is, how much the diseases that the patient may have affect the level of physical functioning.
BMJ Quality & SafetyAdverse events following an emergency department visit
107 Citations2007Alan J. Forster, N. Rose +2 more
Most adverse events occurring following an ED visit are preventable and often relate to diagnostic or management errors.
BMJ Quality & SafetyCase record review of adverse events: a new approach
95 Citations2003Maria Woloshynowych
The existing clinical review form (RF2) used in previous retrospective case record review studies is redesigned in order to clarify the review process and provide a more powerful analysis of adverse events; and then to ask clinicians to pilot and evaluate the new modular reviewform (MRF2).
BMJ Quality & SafetyAdverse events in health care: issues in measurement
86 Citations2000Kieran Walshe
An analysis of the issues involved in defining adverse events, the sources of data which can be used to identify such events, and the validity and reliability of measures of quality based on adverse events in health care is presented.
PubMed[A iatrogenic pathology study in an internal medicine service].
6 Citations1994Sampéreiz Legarre Al, Rubio Obanos +4 more
iatrogenic pathology is an illness of very high incidence in the authors' surroundings and NSA is a group of drugs generating frequently adverse reactions in off-hospital environment; GI hemorrhage is an i atrogenic illness accounting for high percentage of cases; many of the iatrogensic events can be catalogued as avoidable and with more accurate attention to some factors the more of them could be prevented.
Revista de Calidad AsistencialEfectos adversos prehospitalarios: un camino por recorrer
3 Citations2009Nancy Jezzi Álvarez-Ortiz, Jesús María Aranaz Andrés +2 more
The characteristics of patients with AE and undesirable effects that occurred during pre-hospitalization period depended on whether they originated during ambulatory care or non-ambulatory care, and prevention strategies should take these differences into account.