RT Journal Article
SR Electronic
T1 The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP 1678
OP 1686
DO 10.1503/cmaj.1040498
VO 170
IS 11
A1 G. Ross Baker
A1 Peter G. Norton
A1 Virginia Flintoft
A1 Régis Blais
A1 Adalsteinn Brown
A1 Jafna Cox
A1 Ed Etchells
A1 William A. Ghali
A1 Philip Hébert
A1 Sumit R. Majumdar
A1 Maeve O'Beirne
A1 Luz Palacios-Derflingher
A1 Robert J. Reid
A1 Sam Sheps
A1 Robyn Tamblyn
YR 2004
UL http://www.cmaj.ca/content/170/11/1678.abstract
AB Background: Research into adverse events (AEs) has highlighted the need to improve patient safety. AEs are unintended injuries or complications resulting in death, disability or prolonged hospital stay that arise from health care management. We estimated the incidence of AEs among patients in Canadian acute care hospitals. Methods: We randomly selected 1 teaching, 1 large community and 2 small community hospitals in each of 5 provinces (British Columbia, Alberta, Ontario, Quebec and Nova Scotia) and reviewed a random sample of charts for nonpsychiatric, nonobstetric adult patients in each hospital for the fiscal year 2000. Trained reviewers screened all eligible charts, and physicians reviewed the positively screened charts to identify AEs and determine their preventability. Results: At least 1 screening criterion was identified in 1527 (40.8%) of 3745 charts. The physician reviewers identified AEs in 255 of the charts. After adjustment for the sampling strategy, the AE rate was 7.5 per 100 hospital admissions (95% confidence interval [CI] 5.7– 9.3). Among the patients with AEs, events judged to be preventable occurred in 36.9% (95% CI 32.0%–41.8%) and death in 20.8% (95% CI 7.8%–33.8%). Physician reviewers estimated that 1521 additional hospital days were associated with AEs. Although men and women experienced equal rates of AEs, patients who had AEs were significantly older than those who did not (mean age [and standard deviation] 64.9 [16.7] v. 62.0 [18.4] years; p = 0.016). Interpretation: The overall incidence rate of AEs of 7.5% in our 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.