Authors (publication year), Country | Hospital/ Setting/ Sample size | Occurrence of AEs | Characteristics/Types of AEs | Consequences of AEs | Preventable AEs |
---|---|---|---|---|---|
Name of the first author (Publication year), Country/countries | Number of study sites; setting of the study (e.g. medical, surgical, ICU) (number of patients / medical records included in the study) | Frequency of AEs observed in the study | Frequency/Distribution of the characteristics/types of AEs | Consequences of AEs according to classification used in the study (e.g., temporary or permanent harm, death, etc.) | Percentage of AEs judged as preventable |
Akbari et al. (2015), Iran, [34] | 4 general hospitals; medicine, general surgery, urology, orthopaedics, ICU, CCU, A&E, ENT, ophthalmology, paediatrics and women’s health (n = 1162), | 7.3% during stay (3.7% of patients had AEs before admission) | Adverse drug reaction (26.6%); post-op infections (19.5%); pressure ulcers (13.3%); hospital-acquired infections (10.2%); procedural complications (10.2%) | Minimal impairment (< 1 month): 73.4%; moderate impairment (1–12 months): 21.2%; severe impairment: 3.9%; death: 0.8% | 34.3% |
Aranaz-Andres et al. (2011), Argentina, Colombia, Costa Rica, Mexico, Peru, [51] | 58 hospitals; surgery, gynaecology, obstetrics, paediatrics and intensive care (n = 11,379) | 10.5% (1191 patients) had at least one AE | Hospital-acquired infections (37.1%); surgical procedures (28.5%); patient management and nursing care (13.4%); medication (8.2%); diagnostics (6.1%). The 5 most frequent AEs (accounting for 36.2% of all AEs): 127 hospital-acquired pneumonia (9.4%); 111 surgical wound infections (8.2%); 97 pressure ulcers (7.2%); 86 other complications related to surgery or procedure (6.4%) and 67 sepsis (5%). | Any kind of disability: (28.8%); death (5.8%) | 59% |
Aranaz-Andres et al. (2009), Spain, [32] | 24 hospitals, all wards (n = 5624) | 9.3% (525 patients; 655 AEs) had at least one AE | Medication use (37.4%); nosocomial infections (25.3%); procedure-related (25%); care-related (7.6%); diagnosis-related (2.7%); others (1.8%) | Minor: (45%); moderate: (39%) and severe: (16%resulted in a longer stay: (31.4%); death (4.4%) | 42.6% (overall) (84.2% of all diagnostic AEs, 56.6.% of nosocomial infections, 56% care related AEs) |
Baker et al. (2004), Canada, [22] | 20 hospitals; medical-surgical units (n = 3745) | 7.5% (255 patients; 289 AEs) had at least one AE | Surgical procedures (34%), drug-related events (24%), clinical management (12%), diagnostic procedures (11%), medical procedures (7%), others e.g., burns, falls (5%) | Minimal impairment (< 1 month): 64.4%; moderate impairment (1–12 months): 12.5%; permanent impairment: 5.2%; death: 15.9% | 36.9% |
Brennan et al. (1991), US, [6] | 51 hospitals; acute care (n = 30,121) | 3.7% (1278 AEs) | Not stated | Minimal impairment (= < 1 month): 56.8%; moderate impairment (> 1 month): 16.5%; permanent disability: 6.5%; death: 13.6% | Preventability not stated;27.6% AE due to negligence |
D’Amour et al. (2014), Canada, [52] | 11 hospitals; medical units (n = 2699) | 15.3% (412 patients; 568 AEs) had at least one AE | Falls (40.5%); administration errors (29.7%); urinary tract infection (12.3%); pressure ulcers (9.1%); inappropriate use of restraints (4.2%); medication pneumonia (4.0%) | 167 of AE (29.4%) had consequences | Preventability not stated; 76.8% AEs due to inappropriate nursing care |
Davis et al. (2002) & Davis et al. (2003), New Zealand [53, 54] | 13 hospitals; acute care (n = 6579) | 12.9% (850 AEs) | Operative (24.3%), system: (24%), drug (12.3%), therapy (8.4%), diagnosis (8%), procedure (7.7%), other (e.g., falls) (15.3%) | Minimal impairment (< 1 month): 61.6%; moderate impairment (1-12 months): 19.0%, permanent disability: 10.2%; death: 4.5%; unclear (4.7%) | 37.1% |
Forster et al. (2004), Canada, [35] | 1 hospital (multi-campus); (n = 502) | 12.7% (64 patients) | Adverse drug events (50%), surgical complications (31%), nosocomial infections (19%), diagnostic errors (9%), system problems (8%), procedure injuries (8%), anaesthetic injuries (2%), obstetric injuries (2%) | Temporary disability: 10.4%; permanent disability: 1.8%; death (not preventable): 0.6% | 37.5% |
Grira et al. (2015), Tunisia, [25] | 1 hospital; internal medicine (n = 500) | 5.2% (26 patients) | Adverse drug events (73%), healthcare associated infections (19%), non-surgical procedures (4%), pressure ulcers (4%) | Prolongation of hospitalization: (27%); disability: (15.4%); readmission: (42.9% of hospitalizations due to AE) | 57.7% |
Halfon et al. (2017), Switzerland, [55] | 1 medium size community hospital; medical and surgical setting (n = 1007) | 12.3% AEs (64 AEs in 55 medical patients, 82 AEs in 72 surgical patients) | Surgical patients: operative procedures (74%), medications (15%), non-surgical procedures (7%), diagnostic procedures (4%), medical patients: medication (52%), non-surgical procedures (27%), operative procedures (11%), therapeutic decisions (6%), diagnostic procedures (5%) | No or minimal impairment: 60%, Severe impairment: 23% | 42% |
Kable et al. (2002), Australia, [28] | 28 hospitals; surgery (n = 5432) | 21.9% (1190 AEs) | Operation-related (74.9%): wound infections (2.1%); bleeding (1.4%), wound problems (1.2%), deep vein thrombosis/pulmonary embolisms (0.3%), and pneumonia (0.2%) | Minimal disability (< 1 month): 46.9%, moderate impairment (1-12 months): 36.1%,permanent disability: 17%; death: 4.0% | 47.6% (highly preventable) |
Letaief et al. (2010), Tunisia, [33] | 1 hospital; 18 units (n = 620) | 10% (62 AEs) | Surgical/invasive related (54.8%), therapeutic errors (20.9%), diagnostic errors (12.9%), drug-related (6.5%); others (4.9%) | Minimal impairment (< 1 month): 16.1%moderate impairment (1–12 months):56.5%permanent disability: 6.4%; death: 21% | 60% |
Mendes et al. (2009), Brazil, [56] | 3 hospitals; acute care (n = 1103) | 7.6% had at lease one AE (84 patients; 103 AEs) | Surgical procedures (35.2%), medical procedures(30.6%), diagnoses (10.2%), obstetric (8.3%), medication (5.6%,), fractures (1.9%), anaesthetic (0.9%), system events (6.5%), others (0.9%) | Not stated | 66.7% |
Rafter et al. (2017), Ireland, [57] | 8 hospitals; acute care (n = 1574) | 12.2% (247 AEs) | Operation related (25.48%), therapeutic events (24.55%), medication related (14.1%), diagnostic events (11.55%), other events, not covered elsewhere (9.25%), non surgical procedure related (7.9%), fracture related (3.92), pregnancy related (1.17%), anaesthetic related (1.14%), fluid related (0.94%) | Minimal impairment (< 1 month): 33.6%moderate impairment (1–12 months): 25.8% permanent disability: 9.9%; death: 6.7% | 72.7% |
Sari et al. (2007), England, [29] | 1 hospital (n = 1006) | 13.5% (136 AEs) | Not stated | Not stated | Not stated |
Sommella et al. (2014), Italy, [26] | 1 hospital (n = 1501) | 3.3% (46 AEs) | Not stated | Not stated | Not stated |
Soop et al. (2009), Sweden, [58] | 28 hospitals; acute care units (n = 1967) | 12.3% (241 AEs) | Invasive procedures including surgical operations (49.4%), drug treatment (30.1%), diagnostic procedure (11.3%), other procedures (14.2%) | Minimal impairment (< 1 months): 53.5% moderate impairment (1–12 months): 29.8% permanent disability: 10.8%; death: 4.1% | 70.1% |
Sousa et al. (2014), Portugual, [30] | 3 hospitals; acute care (n = 1669) | 11.1% (186 AEs) | Surgical related (27%), drug errors (18.3%), hospital acquired infections (12.2%) | Minimal impairment (< 1 months): 61% moderate impairment (1–12 months): 4.1% permanent disability: 5.7%; death: 10.8% | 53.2% |
Tartaglia (2012), Italy, [59] | 5 hospitals (n = 7573) | 5.2% (n = 470 Aes in 386 patients) | Medical patients (37.5%), surgical patients (30.1%), emergency department (6.2%), obstetric patients (4.4%), | Prolongation of hospitalization (66.7%); disability (18.0%); death (10.6%) | 56.7% |
Thomas et al. (2000), US, [27] | 28 hospitals; all acute care units (n = 14,700) | 2.9% (587 AEs) | Surgery (44.9%), drugs (19.3%), medical procedures (13.5%), diagnoses (6.9%), therapy (4. 3%), obstetric (3.6%), falls (1.3%), fractures (0.4%), others (1.5% | Temporary impairment: 73.8%,permanent impairment: 7.5%; death: 6.6% | Preventability not stated;29.2% negligent AEs |
Vincent et al. (2001), Great Britain, [23] | 2 hospitals; general medicine, general surgery, orthopaedics, obstetrics (n = 1014) | 10.8% (110 patients, 119 AEs) with at least one AEs | General medicine (9.2%), general surgery (16.2%), obstetrics (4%), orthopaedics (14.4%) | Minimal impairment: 66% moderate impairment: 19%permanent disability: 6%; death: 8% | 48% |
Williams et al. (2008), Scottland, [24] | 2 hospitals, acute medical, surgical and obstetric admissions (n = 354) | 7.9% (Range: 0% obstetrics, 7.2% medicine, 13% surgery) | Nature of problem: medical and nursing management and monitoring (32.1%), infection related (35.7%), technical procedure related (21.4%), drug/i.v. fluid problem (7.1%), fall (3.6%) | No physical impairment (17.9%), minimal physical impairment (35.7%), moderate impairment (28.6%), permanent impairment (7.1%), contributed to patient death (10.7%) | 43% |
Wilson et al. (2012), Egypt, Jordan; Kenya; Morocco; Tunisia; Sudan; South Africa; Yemen; [31] | 26 hospitals; paediatric hospital; obstetric hospital; general public hospital; teaching hospital (n = 15,548) | 8.2% (between country-variability ranging from 2.5 to 18.4%) | Therapeutic errors (34%), diagnostic (18%), operative (17%); obstetrics (8%), neonatal (7%), non-surgical procedures (5%),drug related (4%), fractures (3%), falls (2%), anaesthesia (2%) | Minimal impairment (< 1 months): 32% moderate impairment (1–12 months): 16% permanent disability: 12%; death: 30% | 83% |
Wilson et al. (1995), Australia, [60] | 28 hospitals (n = 14,179) | 16.6% | Operative (50.3%), diagnoses (13.6%), therapy (12%), drug (10.8%), medical procedures (8.6%), fractures (5.5%), obstetrics (5.5%), falls (2.9%), others (19.1%) | Minimal disability: 46.6% permanent disability: 13.7%; death: 4.9% | 51.2% |
Zegers et al. (2009), Netherland, [61] | 21 (university, teaching and general) hospital (n = 7926), | 5.7% (6.8% surgical; 4.8% non-surgical) | Surgery (54.2%), medical procedures (17%), drug/fluid (15.3%), diagnostic (6.3%), other clinical management (3.7%), other (e.g. falls) (2.1%), discharge (1.4%) | No or minimal physical impairment: 56.8%permanent disability: 5.0%; death: 7.8% | 39.6% (surgical: 39.5%, non-surgical 40.3%) |