Background
An adverse event (AE) is an unintended injury that results in temporary or permanent disability, death or prolonged hospital stay, and is caused by healthcare management rather than by the patient’s underlying disease process. Overall, the incidence of AEs among patients admitted to hospital has been reported to be between 2.9% and 16.6%. It has been also reported that surgery-related AEs were the biggest contributor and operating theatres are the most likely location for AEs to occur.
Aims
The aim of our study was to investigate the incidence, preventability and mortality of AEs in gynaecological hospital admissions.
Materials and Methods
A systematic search of the MEDLINE, Embrace, and CINAHL medical databases was performed. Search terms included those corresponding to AEs, patient safety and medical errors combined with terms describing gynaecology or hospital setting. Clinical studies published in peer-reviewed journals in the English language were identified. A manual cross-reference search of the eligible papers was performed to identify additional relevant articles.
Results
The initial database searching identified 2,217 records. A total of 237 duplicates and 1,931 records were removed after screening the titles and abstracts. Of the remaining 49 records, 47 were excluded after reviewing the full-text articles and applying the inclusion and exclusion criteria. In addition, hand-searching the reference lists of potentially relevant articles identified 1 record. Therefore 3 articles in total were included in the study.1-3
These three studies were conducted in three different countries and were published between 1995 and 2009. Two were multi-centre retrospective studies and one was a single-centre prospective study. The number of gynaecological admissions in each study was between 135 and 1,866. The incidence of AEs ranged from 4.7% to 19.7% and preventability was stated to range from 50.0% to 52.0%. The proportion of AEs associated with death was reported in two studies and ranged from 0% to 17.7%.
Conclusions
Evidence on AEs in gynaecological hospital admissions is limited and heterogeneous. It is apparent that AEs cause significant morbidities and mortalities in gynaecology and approximately half of these events are estimated to be preventable.