Incidence, preventability and consequences of adverse events in older people: results of a retrospective case-note review.
OBJECTIVE
to estimate the extent, preventability and consequences of adverse clinical events in elderly and non-elderly patients.


METHODS
a two-stage structured, retrospective, patient case-note review.


METHODS
a large NHS hospital in England.


METHODS
a random sample of 1,006 non-psychiatric patients.


METHODS
proportion of patients with adverse events, the proportion of preventable adverse events and the types and consequences of adverse events in patients >or=75 and under 75 years old.


RESULTS
forty five [13.5%; 95% confidence interval (CI) 10-17] of 332 patients >or=75 years and 42 (6.2%; 95% CI 4-8) of 674 patients <75 years had at least one adverse event. There was a significantly raised risk of experiencing an adverse event with increasing age [odds ratio (OR) = 1.03 adverse events per year of life, P < 0.001]. There was no statistically significant difference in preventability of adverse events and also in experiencing disability or death as a result of an adverse event by age after adjustment for potential confounders.


CONCLUSIONS
adverse events are significantly more common in non-psychiatric elderly inpatients than younger patients. There is little evidence that adverse events in older patients are more preventable and lead to disability or death more frequently.
Sari
Ali B A
AB
Department of Health Economics and Management, Tehran University of Medical Sciences, Poursina Ave, Tehran 1417613191, Iran. akbarisari@tums.ac.ir
Cracknell
Alison
A
Sheldon
Trevor A
TA
D000056:Accident Prevention; D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology / Q000517:prevention & control; D006233:Persons with Disabilities; D064420:Drug-Related Side Effects and Adverse Reactions; D006801:Humans; D015994:Incidence; D007297:Inpatients / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control; D003668:Pressure Ulcer / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology / Q000517:prevention & control; D012189:Retrospective Studies