International Journal for Quality in Health Care 14:269-276 (2002)
© 2002 International Society for Quality in Health Care
Paper |
Adverse events in surgical patients in Australia
1Centre for Clinical Epidemiology and Biostatistics and
3Discipline of Surgical Science, School of Medical Practice, Faculty of Health, University of Newcastle, Newcastle, New South Wales, Australia
2Health Services Research Group, Newcastle, New South Wales, Australia
4Clinical Governance Unit, Hunter Area Health Service, Newcastle, New South Wales, Australia
Objective. To determine the adverse event (AE) rate for surgical patients in Australia.
Design. A two-stage retrospective medical record review was conducted to determine the occurrence of AEs in hospital admissions. Medical records were screened for 18 criteria and positive records were reviewed by two medical officers using a structured questionnaire.
Setting. Admissions in 1992 to 28 randomly selected hospitals in Australia.
Study participants. Five hundred and twenty eligible admissions were randomly selected from in-patient databases in each hospital. A total of 14 179 medical records were reviewed, with 8747 medical and 5432 surgical admissions.
Main outcome measures. Measures included the rate of AEs in surgical and medical admissions, the proportion resulting in permanent disability and death, the proportion determined to be highly preventable, and the identification of risk factors associated with AEs.
Results. The AE rate for surgical admissions was 21.9%. Disability that was resolved within 12 months occurred in 83%, 13% had permanent disability, and 4% resulted in death. Reviewers found that 48% of AEs were highly preventable. The risk of an AE depended on the procedure and increased with age and length of stay.
Conclusion. The high AE rate for surgical procedures supports the need for monitoring and intervention strategies. The 18 screening criteria provide a tool to identify admissions with a greater risk of a surgical AE. Risk factors for an AE were age and procedure, and these should be assessed prior to surgery. Prophylactic interventions for infection and deep vein thrombosis could reduce the occurrence of AEs in hospitals.
Keywords: adverse events, disability, injury, prevention, quality in health care, surgery
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  A. Kable, R. Gibberd, and A. Spigelman Predictors of adverse events in surgical admissions in Australia Int. J. Qual. Health Care, July 24, 2008; (2008) mzn032v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Bartlett PhD, R. Blais PhD, R. Tamblyn PhD, R. J. Clermont MD, and B. MacGibbon PhD Impact of patient communication problems on the risk of preventable adverse events in acute care settings Can. Med. Assoc. J., June 3, 2008; 178(12): 1555 - 1562. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P J M.-v. de Mheen, N van Duijn-Bakker, and J Kievit Adverse outcomes after discharge: occurrence, treatment and determinants Qual. Saf. Health Care, February 1, 2008; 17(1): 47 - 52. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P J Marang-van de Mheen, N van Duijn-Bakker, and J Kievit Surgical adverse outcomes and patients' evaluation of quality of care: inherent risk or reduced quality of care? Postgrad. Med. J., February 1, 2008; 84(988): 93 - 98. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. J Marang-van de Mheen, N. van Duijn-Bakker, and J. Kievit Surgical adverse outcomes and patients' evaluation of quality of care: inherent risk or reduced quality of care? Qual. Saf. Health Care, December 1, 2007; 16(6): 428 - 433. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. J. Marang-van de Mheen, E.-J. F. Hollander, and J. Kievit Effects of study methodology on adverse outcome occurrence and mortality Int. J. Qual. Health Care, December 1, 2007; 19(6): 399 - 406. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Braithwaite, M. T Westbrook, N. A Mallock, J. F Travaglia, and R. A Iedema Experiences of health professionals who conducted root cause analyses after undergoing a safety improvement programme Qual. Saf. Health Care, December 1, 2006; 15(6): 393 - 399. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P J Marang-van de Mheen, M C Stadlander, and J Kievit Adverse outcomes in surgical patients: implementation of a nationwide reporting system. Qual. Saf. Health Care, October 1, 2006; 15(5): 320 - 324. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Van den Heede, W. Sermeus, L. Diya, E. Lesaffre, and A. Vleugels Adverse outcomes in Belgian acute hospitals: retrospective analysis of the national hospital discharge dataset Int. J. Qual. Health Care, June 1, 2006; 18(3): 211 - 219. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P J Marang-van de Mheen, N van Hanegem, and J Kievit Effectiveness of routine reporting to identify minor and serious adverse outcomes in surgical patients Qual. Saf. Health Care, October 1, 2005; 14(5): 378 - 382. [Abstract] [Full Text] [PDF]
|
|