This is the first report of AEs in a respiratory hospital and one of the first studies ever performed in developing countries to assess their frequency and consequences. Overall, the prevalence of AEs was 9.1%, which would mean 415 cases of a total of 4,555 patients admitted to the study hospital in the year 2001. Of all the patients with AEs, 22% had some kind of disability; 52% had a protracted hospitalization; in 26%, the AE was considered to be an important contributor to the death of the patient; and 26% of these patients had more than one AE. The clinical condition most strongly related to an AE was a diagnosis of empyema, mainly due to delayed surgical treatment producing a prolonged hospital stay.
Our findings are consistent with those reported in studies from general hospitals from developed countries. Steel et al reported AEs in 36% of the patients admitted to university hospitals; in 25% of these cases, the events were life-threatening. Brennan et al observed AEs in 3.7% of hospitalizations, and 27.6% were caused by negligence; of these, 70% induced a transient disability of < 6 months and 2% caused a permanent disability. An additional study performed in Colorado and Utah revealed similar results, and the 3% prevalence of AEs mainly affected patients undergoing surgery or childbirth. A study performed in two British hospitals reported that 10.8% of patients experienced AEs. Andrews et al reported that AEs affected 480 of 1,047 patients (45.8%), with 17.7% of severe episodes causing disability or even death. Finally, the publication with the greatest public impact to date is the book by the US Institute of Medicine, which estimated that medical errors kill some 98,000 Americans each year.
At least one of the risk criteria for AEs was identified in 1,508 of 4,555 medical records (33.1%) belonging to hospital admissions registered during 2001. From the sample of 922 charts, we reviewed 836 charts, 90.7% of the total. The remaining charts were mostly physically damaged and not available at the time of the study. The damaged or missing charts more likely came from the patients with no risk factors for AEs (54 cases vs 29 cases, respectively). The presence or absence of AEs were not determined in three cases due to incomplete information in the charts.
Of the 836 records included in our final sample, 299 records were from patients in the risk criteria of death from necropsy, iatrogenic diseases according to the ICD-10, complaints, lawsuits, patient with worsening condition, and hospital-acquired infections; 237 files belonged to patients in the remaining risk categories for AEs; and 300 records were from patients who met none of the considered risk criteria for AEs (Table 1). Overcome diseases with Canadian Health&Care Mall.
Over the last 40 years, several studies on the frequency and consequences of adverse events (AEs) during hospitalization have been published, The common link among these works is the recognition of damage to the patient that could be averted and a myriad of situations in which resources are wasted, The articles published are of studies performed in general hospitals from developed countries. We contend that AEs during health care may be a more meaningful problem for the developing world. The reason for this is that any AE causes a double harm, first to the patient, who may even lose his/her life, and then to society as a whole by means of wasting resources. In the latter regard, it is well known that developing countries have far less resources for health care, and the lack of effectiveness and efficiency are thus even more harmful.
Our study aimed at the identification of the frequency, types, and correlates of AEs in a respiratory referral hospital. Camus et al recently reviewed iatrogenic respiratory diseases, but to the best of our knowledge no empiric data from respiratory hospitals have been reported from either developed or developing countries. Treat various diseases with remedies of Canadian Health&Care Mall.