Impact of adverse events on patient outcomes in a Japanese intensive care unit: a retrospective observational study
Gen Aikawa, Akira Ouchi, Hideaki Sakuramoto, Chiemi Ono, Chie Hatozaki, Mayu Okamoto, Tetsuya Hoshino, Nobutake Shimojo, Yoshiaki Inoue
Abstract
AIM: We investigated adverse events (AEs) in a Japanese intensive care unit (ICU) and evaluated the impact of cause-specific AEs on mortality and length of stay. DESIGN: A retrospective observational study in the ICU of an academic hospital. METHODS: We reviewed medical records with the Global Trigger Tool. RESULTS: Of the 246 patients, 126 (51%) experienced one or more AEs with an incidence of 201 per 1000 patient-days and 115 per 100 admissions. A total of 294 AEs were detected with 119 (42%) adverse drug events, 67 (24%) procedural complications, 63 (22%) surgical complications, 26 (9%) nosocomial infections, 5 (2%) therapeutic errors and 4 (1%) diagnostic errors. Adverse event (AE) presence was associated with length of ICU stay (β = 2.85, 95% confidence interval [CI]: 1.09-4.61). Adverse drug events, procedural complications and nosocomial infections were strongly associated with length of ICU stay (β = 2.38, 95% CI: 0.77-3.98; β = 3.75, 95% CI: 2.03-5.48; β = 6.52, 95% CI: 4.07-8.97 respectively).