Frequency and correlates of adverse events in a respiratory diseases hospital in Mexico city.
OBJECTIVE
To estimate the frequency of severe adverse events (AEs) during hospital stay as well as their type and correlates in a referral hospital for respiratory diseases, using methods similar to those used in the Harvard Medical Malpractice Study.


METHODS
Retrospective review of medical records in a stratified sample of 836 patients drawn from a total of 4,555 hospital admissions registered during the year 2001.


METHODS
A referral tertiary-care hospital for patients with respiratory diseases located in Mexico City.


METHODS
Weighted prevalence of AEs and odds ratios for correlates.


RESULTS
The overall weighted prevalence for AEs was 9.1% (95% confidence interval, 7.5 to 10.4%). Of these patients, 17% had a related transient disability, 52% had a prolonged hospital stay, and 26% had an AE that according to the reviewers contributed to their death. Of the total number of AEs, 74% were qualified as potentially preventable. Among all types of AEs, we identified as most relevant for a chest hospital the delayed surgical treatment of empyema, representing 11% of the total.


CONCLUSIONS
The frequency of AEs in a tertiary-care respiratory hospital is similar to that reported in general hospitals. A strategy to improve the treatment of empyema is needed.
Herrera-Kiengelher
Loredmy
L
National Institute of Respiratory Diseases and National Institute of Public Health, Secretary of Health, Mexico, Tlalpan, Mexico.
Chi-Lem
Georgina
G
Báez-Saldaña
Renata
R
Torre-Bouscoulet
Luis
L
Regalado-Pineda
Justino
J
López-Cervantes
Malaquías
M
Pérez-Padilla
Rogelio
R
D000328:Adult; D016907:Adverse Drug Reaction Reporting Systems; D017677:Age Distribution; D000368:Aged; D002423:Cause of Death; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D019300:Medical Errors / Q000706:statistics & numerical data*; D008499:Medical Records; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D015588:Observer Variation; D011336:Probability; D012140:Respiratory Tract Diseases / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D018570:Risk Assessment; D017751:Safety Management / Q000592:standards*; D017678:Sex Distribution; D016019:Survival Analysis