Incidência de eventos adversos em hospitais suecos: um estudo baseado na revisão retrospectiva de prontuários médicos
Objectives: To estimate the incidence, nature and consequences of adverse events and preventable adverse events in Swedish hospitals.
Design: A three-stage structured retrospective medical record review based on the use of 18 screening criteria.
Setting: Twenty-eight Swedish hospitals.
Population: A representative sample (n = 1967) of the 1.2 million Swedish hospital admissions between October 2003 and September 2004.
Main Outcome Measures: Proportion of admissions with adverse events, the proportion of preventable adverse events and the types and consequences of adverse events.
Results: In total, 12.3% (n = 241) of the 1967 admissions had adverse events 95% CI, 10.8–13.7, of which 70% (n = 169) were preventable. Fifty-five percent of the preventable events led to impairment or disability, which was resolved during the admission or within 1 month from discharge, another 33% were resolved within 1 year, 9% of the preventable events led to permanent disability and 3% of the adverse events contributed to patient death. Preventable adverse events led to a mean increased length of stay of 6 days. Ten of the 18 screening criteria were sufficient to detect 90% of the preventable adverse events. When extrapolated to the 1.2 million annual admissions, the results correspond to 105 000 preventable adverse events (95% CI, 90 000–120 000) and 630 000 days of hospitalization (95% CI, 430 000–830 000).
Conclusions: This study confirms that preventable adverse events were common, and that they caused extensive human suffering and consumed a significant amount of the available hospital resources.
