PMID- 33734205
OWN - NLM
STAT- MEDLINE
DCOM- 20211124
LR  - 20230928
IS  - 1549-8425 (Electronic)
IS  - 1549-8417 (Linking)
VI  - 17
IP  - 3
DP  - 2021 Apr 1
TI  - The Incidence and Preventability of Adverse Events in Older Acutely Admitted 
      Patients: A Longitudinal Study With 4292 Patient Records.
PG  - 166-173
LID - 10.1097/PTS.0000000000000727 [doi]
AB  - OBJECTIVES: Acute care crowding is a global issue, jeopardizing patient safety. 
      An important cause of crowding is the growing number of older, vulnerable, and 
      complex patients. This group is at higher risk of experiencing (preventable) 
      adverse events (AEs) than younger patients.This study aimed to identify the 
      incidence, preventability, nature, and prevention strategies of AEs in older 
      patients during an acute hospital admission and to assess changes over time. 
      METHODS: We analyzed data of 4292 acutely admitted patients (70+) who died in the 
      hospital, using data of a multicenter Dutch AE record review study (2008, 2012, 
      2016). Multilevel logistic regression analyses were performed to adjust for 
      patient-mix differences and clustering on department/hospital level per year. 
      RESULTS: The incidence of AEs in this group declined significantly (chi2(1) = 8.78, 
      P = 0.003) from 10.7% (95% confidence interval [CI] =8.2-13.9) in 2008, 7.4% (95% 
      CI = 5.6-9.7) in 2012, to 7.2% (95% CI = 5.5-9.3) in 2016. The relative 
      preventability showed a significant parabolic trend (chi2(1) = 4.86, P = 0.027), 
      from 46.2% (95% CI = 34.1-58.7), to 32.4% (95% CI = 21.1-46.1), to 44.6% (95% CI 
      = 32-58). Adverse events were often related to medication (26.3% in 2008, 35.1% 
      in 2012, and 39.5% in 2016), and the preventability in AEs related to diagnosis 
      was highest (88.3%, 70.8%, and 79.9%). CONCLUSIONS: The incidence of AEs in older 
      acutely admitted patients declined over the years; however, the preventability 
      increased again after an initial decline. This could be related to crowding or 
      increasing complexity in the acute care chain. Further monitoring and improvement 
      in (preventable) AE rates are necessary to pinpoint areas of improvement to make 
      hospital care for this vulnerable group safer.
CI  - Copyright (c) 2020 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Schouten, Bo
AU  - Schouten B
AD  - From the Department of Public and Occupational Health, Amsterdam UMC, Vrije 
      Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam.
FAU - Merten, Hanneke
AU  - Merten H
AD  - From the Department of Public and Occupational Health, Amsterdam UMC, Vrije 
      Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam.
FAU - Spreeuwenberg, Peter M M
AU  - Spreeuwenberg PMM
AD  - Netherlands Institute for Health Services Research (NIVEL), Utrecht.
FAU - Nanayakkara, Prabath W B
AU  - Nanayakkara PWB
FAU - Wagner, Cordula
AU  - Wagner C
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Patient Saf
JT  - Journal of patient safety
JID - 101233393
SB  - IM
MH  - Aged
MH  - *Hospitalization
MH  - Humans
MH  - Incidence
MH  - Longitudinal Studies
MH  - *Medical Errors/prevention & control
MH  - Retrospective Studies
COIS- The authors disclose no conflict of interest.
EDAT- 2021/03/19 06:00
MHDA- 2021/11/25 06:00
CRDT- 2021/03/18 12:37
PHST- 2021/03/18 12:37 [entrez]
PHST- 2021/03/19 06:00 [pubmed]
PHST- 2021/11/25 06:00 [medline]
AID - 01209203-202104000-00002 [pii]
AID - 10.1097/PTS.0000000000000727 [doi]
PST - ppublish
SO  - J Patient Saf. 2021 Apr 1;17(3):166-173. doi: 10.1097/PTS.0000000000000727.