title: Scale, nature, preventability and causes of adverse events in hospitalised older patients.
abstract: OBJECTIVE
  to gain insight into the scale, nature, preventability and causes of adverse events in hospitalised older patients.
  
  
  METHODS
  a three-stage retrospective, structured, medical record review study of 7,917 records of patients admitted in 21 Dutch hospitals in 2004.
  
  
  METHODS
  incidence, preventability, clinical process category, consequences and causes of adverse events in hospitalised patients of 65 years and older, compared with patients younger than 65.
  
  
  RESULTS
  adverse events and preventable adverse events occur significantly more often in older patients [6.9% (95% CI: 5.9-8.0%) and 2.9% (95% CI: 2.3-3.7%), respectively] than in younger patients [4.8% (95% CI: 4.0-5.7%) and 1.8% (95% CI: 1.3-2.4%), respectively]. In older patients, the adverse events were more often related to medication (20.1 versus 9.6%) (P < 0.01). An exploration of the causes revealed that the inability to apply existing knowledge to a new and complex situation contributes more often to the occurrence of adverse events in older patients than in younger patients (36.4 versus 24.3%) (P < 0.05).
  
  
  CONCLUSIONS
  to reduce the number of adverse events in older patients in the future, more particular training of hospital staff in geriatric medicine is required, with a specific focus on medication.
authors.affiliation: Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. h.merten@vumc.nl
authors.forename: Hanneke
authors.initials: H
authors.lastname: Merten
authors.forename: Marieke
authors.initials: M
authors.lastname: Zegers
authors.forename: Martine C
authors.initials: MC
authors.lastname: de Bruijne
authors.forename: Cordula
authors.initials: C
authors.lastname: Wagner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D019300:Medical Errors / Q000009:adverse effects / Q000145:classification / Q000517:prevention & control* / Q000706:statistics & numerical data; D008875:Middle Aged; D009426:Netherlands; D061214:Patient Safety / Q000706:statistics & numerical data*; D012189:Retrospective Studies