Adverse Events in General Surgery. A Prospective Analysis of 13950 Consecutive Patients

Introduction Adverse event (AE) rates in general surgery vary, according to different authors and recording methods, between 2% and 30%. Six years ago we designed a prospective AE recording system to change patient safety culture in our department. We present the results of this work after a 6-year follow-up. Material and method The AE, sequelae and health care errors in a University Hospital surgery department were recorded. An analysis of each incident recorded was performed by a reviewer. The data were entered into database for rapid access and consultation. The results were routinely presented in departmental morbidity–mortality sessions. Results A total of 13 950 patients had suffered 11 254 AE, which affected 5142 of them (36.9% of admissions). A total of 920 patients were subjected to at least one health care error (6.6% of admissions). This meant that 6.6% of our patients suffered an avoidable AE. The overall mortality at 5 years in our department was 2.72% (380 deaths). An adverse event was implicated in the death of the patient in 180 cases (1.29% of admissions). In 49 cases (0.35% of admissions), mortality could be attributed to an avoidable AE. After 6 years there tends to be an increasingly lower incidence of errors. Conclusions The exhaustive and prospective recording of AE leads to changes in patient safety culture in a surgery department and helps decrease the incidence of health care errors.