title: Can preventable adverse events be predicted among hospitalized older patients? The development and validation of a predictive model.
abstract: OBJECTIVE
  To develop and validate a predictive model for preventable adverse events (AEs) in hospitalized older patients, using clinically important risk factors that are readily available on admission.
  
  
  METHODS
  Data from two retrospective patient record review studies on AEs were used. Risk factors included patient characteristics as well as admission and organizational characteristics. Multilevel logistical regression analysis was used to develop the model. Backward elimination was applied to identify the most parsimonious model.
  
  
  METHODS
  Twenty-one Dutch hospitals were included in the 2004 sample and 20 Dutch hospitals in the 2008 sample.
  
  
  METHODS
  A total of 3977 patients aged 70 years or over who were admitted to a Dutch hospital in 2004 and 2119 patients aged 70 years or over admitted in 2008.
  
  
  METHODS
  Identified predictors of preventable AEs in older patients.
  
  
  RESULTS
  In 2004 predictors of preventable AEs in patients aged 70 years or over were increased age (OR 1.04, confidence interval (CI) 1.01-1.06); elective admission (OR 1.65, CI 1.14-2.40) and admission to a surgical department (OR 1.53, CI 1.08-2.16). The area under the receiver operating characteristic curve for the 2004 sample was 0.60 and for 2008, 0.59.
  
  
  CONCLUSIONS
  This study showed that several expected risk factors for preventable AEs in older patients, including comorbidity, could not predict these events. It was not possible, using in-patient data available on admission and collected during the course of two patient record review studies, to develop a satisfactory predictive model for preventable AEs in older patients.
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, PO Box 1568, Utrecht 3500 BN, The Netherlands.
authors.forename: L
authors.initials: L
authors.lastname: Van De Steeg
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, PO Box 1568, Utrecht 3500 BN, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Langelaan
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, PO Box 1568, Utrecht 3500 BN, The Netherlands EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: C
authors.initials: C
authors.lastname: Wagner
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009426:Netherlands; D010343:Patient Admission; D061214:Patient Safety / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors
keywords: adverse events; elderly; hospital care; predictors; risk factors