Adverse Events Affect Over 38% Surgery Patients: BMJ Study Finds - Video

Adverse events affect more than a third (38%) of adults undergoing surgery, finds a study of admissions to 11 hospitals in the US state of Massachusetts, published by The BMJ. Of the 1009 admissions analyzed, nearly half were classified as major resulting in serious, life-threatening or fatal harm, and the majority were considered as potentially preventable.

Researchers set out to estimate the frequency, severity, and preventability of adverse events associated with perioperative care, and to describe the setting and professions concerned.

Their findings are based on a randomly selected sample of 1009 patients aged 18 years and older admitted to 11 hospitals for surgery during 2018. The hospitals were chosen to represent a mix of large and small facilities across three different healthcare systems and estimates were weighted to take account of differences in the sample population.

Trained nurses reviewed all records and flagged admissions with possible adverse events, which were then adjudicated by physicians. Adverse events were classified as major if they resulted in serious harm requiring significant intervention or prolonged recovery, involved a life-threatening event, or led to a fatal outcome. The severity and preventability of adverse events were also assessed according to the type of event, setting, and profession involved. Of the 1009 reviewed admissions, adverse events were identified in 383, with major adverse events occurring in 160.

Of 593 identified adverse events, 60% were potentially preventable and 21% were definitely or probably preventable. The most common adverse events were related to surgical procedures (49%), followed by adverse drug events (27%), healthcare-associated infections (12%), patient care events, such as a fall or pressure ulcer (11%), and blood transfusion reactions (0.5%). Half of these events took place in general care units, followed by operating rooms (26%), intensive care units (13%), and other in-hospital locations (7%). Professions most often involved were attending physicians (90%), followed by nurses (59%), residents (50%), and advanced level practitioners (29%).