title: Association between language, serious adverse events, and length of stay among hospitalized children.
abstract: OBJECTIVE
  To evaluate the risk for serious/sentinel adverse events among hospitalized children according to race, ethnicity, and language and to evaluate factors affecting length of stay associated with serious/sentinel adverse events.
  
  
  METHODS
  We conducted a retrospective cohort study of all pediatric inpatients at a large children's hospital from October 2007 to October 2009. We evaluated the relationship between self-reported race, ethnicity, and primary language; with having a serious or sentinel adverse event, defined as an unexpected occurrence involving risk of death or serious injury; or a potentially harmful event resulting from nonstandard practice. We also examined length of stay. Clinical complexity was adjusted for by using Clinical Risk Groups.
  
  
  RESULTS
  Of 33885 patients, 8% spoke Spanish and 4% spoke other languages. Serious and sentinel events were rare; however, among patients with such events, 14% spoke Spanish. Adjusting for potential confounders, Spanish speakers trended toward an elevated odds of adverse event (odds ratio: 1.83 [95% confidence interval: 0.98-3.39]). Controlling for age, language, and clinical complexity, having an adverse event was associated with a nearly fivefold increase in length of stay (95% confidence interval: 3.87-6.12). Spanish-speaking patients with an adverse event were hospitalized significantly longer than comparable English speakers (26 vs 12.7 days; P = .03 for interaction between language and adverse event).
  
  
  CONCLUSIONS
  Hospitalized children from Spanish-speaking families had significantly longer hospital stays in association with an adverse event and may have increased odds of a serious or sentinel event. These findings suggest that an important component of patient safety may be to address communication barriers.
authors: Department of Pediatrics, University of Washington, Seattle, Washington, USA. casey.lion@seattlechildrens.org
authors: K Casey
authors: KC
authors: Lion
authors: Sarah A
authors: SA
authors: Rafton
authors: Jaleh
authors: J
authors: Shafii
authors: Dena
authors: D
authors: Brownstein
authors: Eriberto
authors: E
authors: Michel
authors: Michelle
authors: M
authors: Tolman
authors: Beth E
authors: BE
authors: Ebel
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003144:Communication Barriers; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007802:Language; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D019300:Medical Errors / Q000706:statistics & numerical data*; D016017:Odds Ratio; D012189:Retrospective Studies; D044465:White People / Q000706:statistics & numerical data*