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Review
. 2008 Jun;17(3):216-23.
doi: 10.1136/qshc.2007.023622.

The incidence and nature of in-hospital adverse events: a systematic review

E N de Vries  1 , M A Ramrattan, S M Smorenburg, D J Gouma, M A Boermeester
Affiliations
Review

The incidence and nature of in-hospital adverse events: a systematic review

E N de Vries et al. Qual Saf Health Care. 2008 Jun.

Abstract

Introduction: Adverse events in hospitals constitute a serious problem with grave consequences. Many studies have been conducted to gain an insight into this problem, but a general overview of the data is lacking. We performed a systematic review of the literature on in-hospital adverse events.

Methods: A formal search of Embase, Cochrane and Medline was performed. Studies were reviewed independently for methodology, inclusion and exclusion criteria and endpoints. Primary endpoints were incidence of in-hospital adverse events and percentage of preventability. Secondary endpoints were adverse event outcome and subdivision by provider of care, location and type of event.

Results: Eight studies including a total of 74 485 patient records were selected. The median overall incidence of in-hospital adverse events was 9.2%, with a median percentage of preventability of 43.5%. More than half (56.3%) of patients experienced no or minor disability, whereas 7.4% of events were lethal. Operation- (39.6%) and medication-related (15.1%) events constituted the majority. We present a summary of evidence-based interventions aimed at these categories of events.

Conclusions: Adverse events during hospital admission affect nearly one out of 10 patients. A substantial part of these events are preventable. Since a large proportion of the in-hospital events are operation- or drug-related, interventions aimed at preventing these events have the potential to make a substantial difference.

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Conflict of interest statement

Competing interests: None.

Figures

Figure 1
Figure 1. Flow chart of article retrieval. AE, adverse event.
See this image and copyright information in PMC

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