PROPORTION OF HOSPITAL DEATHS ASSOCIATED WITH ADVERSE EVENTS

Objectives: To determine the fraction of hospital deaths potentially a ssociated with the occurrence of adverse events (AE). Design: A paired (1:1) case-control study. Setting: An 800-bed, teaching tertiary care hospital. Patients: All patients older than 14 years admitted to the hospital between January 1, 1990, and January 1, 1991, were eligible. All 524 consecutive deaths (death rate of 3.74%) that occurred in the hospital comprised the case group. For each case, a control patient wa s matched for both primary diagnosis on admission and admission date. Measurements: The proportion of hospital deaths associated with advers e events (defined as problems of any nature and seriousness faced by t he patient during hospitalization, and potentially traceable to clinic al or administrative management) was estimated from attributable risks adjusted for age, sex, service, severity of illness, length of stay, and quality of the medical record. Results: For stays longer than 48 h ours, the adjusted attributable risk for all adverse events was estima ted to be 0.51 (0.40-0.61). When the data were stratified according to the category of adverse event, the attributable risks remained signif icant except for administrative problems. The greatest proportion of d eaths associated with adverse events was observed for surgical adverse events [0.56 (0.38-0.71)] and nosocomial infection [0.22 (0.14-0.28)] . Conclusions: A significant proportion of intrahospital deaths were a ssociated with AE. These results suggest the need to consider programs focused on the prevention of mortality from AE. (C) 1997 Elsevier Sci ence Inc.