title: [Adverse events in general surgery. A prospective analysis of 13,950 consecutive patients].
abstract: BACKGROUND
  Adverse event (AE) rates in General Surgery vary, according to different authors and recording methods, between 2% and 30%. Six years ago we designed a prospective AE recording system to change patient safety culture in our Department. We present the results of this work after a 6 year follow-up.
  
  
  METHODS
  The AE, sequelae and health care errors in a University Hospital surgery department were recorded. An analysis of each incident recorded was performed by a reviewer. The data was entered into data base for rapid access and consultation. The results were routinely presented in Departmental morbidity-mortality sessions.
  
  
  RESULTS
  A total of 13,950 patients had suffered 11,254 AE, which affected 5142 of them (36.9% of admissions). A total of 920 patients were subjected to at least one health care error (6.6% of admissions). This meant that 6.6% of our patients suffered an avoidable AE. The overall mortality at 5 years in our department was 2.72% (380 deaths). An adverse event was implicated in the death of the patient in 180 cases (1.29% of admissions). In 49 cases (0.35% of admissions), mortality could be attributed to an avoidable AE. After 6 years there tends to be an increasingly lower incidence of errors.
  
  
  CONCLUSIONS
  The exhaustive and prospective recording of AE leads to changes in patient safety culture in a Surgery Department and helps decrease the incidence of health care errors.
authors.affiliation: Servicio de Cirugía General, Hospital Universitari Parc Taulí, Sabadell, Barcelona, Spain. prebasa@tauli.cat
authors.forename: Pere
authors.initials: P
authors.lastname: Rebasa
authors.forename: Laura
authors.initials: L
authors.lastname: Mora
authors.forename: Helena
authors.initials: H
authors.lastname: Vallverdú
authors.forename: Alexis
authors.initials: A
authors.lastname: Luna
authors.forename: Sandra
authors.initials: S
authors.lastname: Montmany
authors.forename: Andreu
authors.initials: A
authors.lastname: Romaguera
authors.forename: Salvador
authors.initials: S
authors.lastname: Navarro
mesh_terms: D005500:Follow-Up Studies; D006801:Humans; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D013514:Surgical Procedures, Operative / Q000009:adverse effects*