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Adverse event rate declined among patients hospitalized for MI, congestive HF
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Adverse event rates among patients hospitalized with acute MI or congestive HF declined significantly from 2005 to 2011, but not for patients with pneumonia or conditions requiring surgery, researchers reported in The New England Journal of Medicine.
To estimate trends in the rate of occurrence of adverse events, researchers evaluated data collected from the Medicare Patient Safety Monitoring System. Their analysis included 61,523 patients aged at least 65 years who were hospitalized for pneumonia (n=18,269), conditions requiring surgery (n=16,481), congestive HF (n=15,374) or acute MI (n=11,399), and were discharged between 2005 and 2011.
Incidence rates of 21 adverse events among these patients were assessed and compared during the 7-year period, with events grouped into four types: adverse drug events, general events, postprocedural events and hospital-acquired infections. All patients were considered at risk for at least two events during hospitalization: falls and pressure ulcers. Patients were considered at risk for two to 18 events per hospitalization, depending on the condition and patient.
Among patients with acute MI, the incidence of adverse events for which patients were at risk declined from 2005 (5% of patients) to 2011 (3.7%). A similar trend was observed for the proportion of patients who experienced one or more adverse events (26% of patients in 2005 to 19.4% in 2011). The number of events per 1,000 hospitalizations also decreased from 401.9 in 2005 to 262.2 in 2011 (P<.01 for all).
Similar declines in adverse event rates occurred among patients with congestive HF, including the rate of occurrence of at-risk events (from 3.7% in 2005 to 2.7% in 2011), proportion of patients experiencing one or more events (from 17.5% to 14.2%) and number of events per 1,000 hospitalizations (from 235.2 to 166.9; P<.01 for all).
No significant changes in adverse event rates were observed among patients with pneumonia or conditions requiring surgery.
Researchers calculated an adjusted annual decline in adverse events per 1,000 hospitalizations of 4.7% across all four conditions. Specifically, patients with acute MI or congestive HF experienced significant declines in infection- and drug-related adverse events, whereas postprocedural event incidence also improved among those with congestive HF. Patients with conditions requiring surgery experienced a significant increase in both infection-related and postprocedural adverse events.
“Although this suggests that national efforts focused on patient safety have made some inroads, the lack of reductions across the board is disappointing,” researchers wrote. “We report these events to provide much-needed current and past data on the rates of adverse events and in the hope that future efforts to prevent patient harm will be increasingly effective.”
Disclosure: See the full study for a list of the researchers’ relevant financial disclosures.
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