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Age and Ageing Advance Access originally published online on March 10, 2008
Age and Ageing 2008 37(3):265-269; doi:10.1093/ageing/afn043
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Copyright © The Author 2008. Published by Oxford University Press on behalf of the British Geriatrics Society.

Incidence, preventability and consequences of adverse events in older people: results of a retrospective case-note review

Ali B. A. Sari1, Alison Cracknell2 and Trevor A. Sheldon3

1 Department of Health Economics and Management, Tehran University of Medical Sciences, Poursina Ave, Tehran 1417613191, Iran
2 St James's University Hospital, Beckett Street, Leeds LS9 7TF, UK
3 Department of Health Sciences, University of York, Heslington Hall, Heslington, York YO10 5DD, UK

Address correspondence to: Ali B. A. Sari. Tel: +98 (0) 9127251294; Fax: +98 (0) 21 88989129. Email: akbarisari{at}tums.ac.ir

Objectives: to estimate the extent, preventability and consequences of adverse clinical events in elderly and non-elderly patients.

Design: a two-stage structured, retrospective, patient case-note review.

Setting: a large NHS hospital in England.

Population: a random sample of 1,006 non-psychiatric patients.

Main Outcome Measures: proportion of patients with adverse events, the proportion of preventable adverse events and the types and consequences of adverse events in patients ≥75 and under 75 years old.

Results: forty five [13.5%; 95% confidence interval (CI) 10–17] of 332 patients ≥75 years and 42 (6.2%; 95% CI 4–8) of 674 patients <75 years had at least one adverse event. There was a significantly raised risk of experiencing an adverse event with increasing age [odds ratio (OR) = 1.03 adverse events per year of life, P < 0.001]. There was no statistically significant difference in preventability of adverse events and also in experiencing disability or death as a result of an adverse event by age after adjustment for potential confounders.

Conclusion: adverse events are significantly more common in non-psychiatric elderly inpatients than younger patients. There is little evidence that adverse events in older patients are more preventable and lead to disability or death more frequently.

Keywords: adverse events, case-note review, prevention, older people, patient safety

Received 8 May 2007; accepted in revised form 1 November 2007.


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