RT Journal Article SR Electronic T1 Adverse events among children in Canadian hospitals: the Canadian Paediatric Adverse Events Study JF Canadian Medical Association Journal JO CMAJ FD Canadian Medical Association SP E709 OP E718 DO 10.1503/cmaj.112153 VO 184 IS 13 A1 Anne G. Matlow A1 G. Ross Baker A1 Virginia Flintoft A1 Douglas Cochrane A1 Maitreya Coffey A1 Eyal Cohen A1 Catherine M.G. Cronin A1 Rita Damignani A1 Robert Dubé A1 Roger Galbraith A1 Dawn Hartfield A1 Leigh Anne Newhook A1 Cheri Nijssen-Jordan YR 2012 UL http://www.cmaj.ca/content/184/13/E709.abstract AB Background: Limited data are available on adverse events among children admitted to hospital. The Canadian Paediatric Adverse Events Study was done to describe the epidemiology of adverse events among children in hospital in Canada.Methods: We performed a 2-stage medical record review at 8 academic pediatric centres and 14 community hospitals in Canada. We reviewed charts from patients admitted from April 2008 through March 2009, evenly distributed across 4 age groups (0 to 28 d; 29 to 365 d; > 1 to 5 yr and > 5 to 18 yr). In stage 1, nurses and health records personnel who had received training in the use of the Canadian Paediatric Trigger Tool reviewed medical records to detect triggers for possible adverse events. In stage 2, physicians reviewed the charts identified as having triggers and described the adverse events.Results: A total of 3669 children were admitted to hospital during the study period. The weighted rate of adverse events was 9.2%. Adverse events were more frequent in academic pediatric centres than in community hospitals (adjusted odds ratio [OR] 2.98, 95% confidence interval [CI] 1.65–5.39). The incidence of preventable adverse events was not significantly different between types of hospital, but nonpreventable adverse events were more common in academic pediatric centres (adjusted OR 4.39, 95% CI 2.08–9.27). Surgical events predominated overall and occurred more frequently in academic pediatric centres than in community hospitals (37.2% v. 21.5%, relative risk [RR] 1.7, 95% CI 1.0–3.1), whereas events associated with diagnostic errors were significantly less frequent (11.1% v. 23.1%, RR 0.5, 95% CI 0.2–0.9).Interpretation: More children have adverse events in academic pediatric centres than in community hospitals; however, adverse events in the former are less likely to be preventable. There are many opportunities to reduce harm affecting children in hospital in Canada, particularly related to surgery, intensive care and diagnostic error.