Outcome of adverse events and medical errors in the intensive care unit: a systematic review and meta-analysis
Adil H Ahmed1, Jyothsna Giri2, Rahul Kashyap2
1Mayo Clinic, Rochester, MN ahmed.adil@mayo.edu.
Abstract:
Adverse events and medical errors (AEs/MEs) are more likely to occur in the intensive care unit (ICU). Information about the incidence and outcomes of such events is conflicting. A systematic review and meta-analysis were conducted to examine the effects of MEs/AEs on mortality and hospital and ICU lengths of stay among ICU patients. Potentially eligible studies were identified from 4 major databases. Of 902 studies screened, 12 met the inclusion criteria, 10 of which are included in the quantitative analysis. Patients with 1 or more MEs/AEs (vs no MEs/AEs) had a nonsignificant increase in mortality (odds ratio = 1.5; 95% confidence interval [CI] = 0.98-2.14) but significantly longer hospital and ICU stays; the mean difference (95% CI) was 8.9 (3.3-14.7) days for hospital stay and 6.8 (0.2-13.4) days for ICU. The ICU environment is associated with a substantial incidence of MEs/AEs, and patients with MEs/AEs have worse outcomes than those with no MEs/AEs.
Insights
Medical errors and adverse events in the intensive care unit (ICU) are common. Patients experiencing these events face significantly longer hospital and ICU stays, highlighting the need for improved patient safety protocols.
Area of Science:
- Critical Care Medicine
- Patient Safety
- Medical Informatics
Background:
- Intensive care units (ICUs) are high-risk environments for adverse events and medical errors (AEs/MEs).
- Existing data on the incidence and outcomes of AEs/MEs in ICUs is conflicting.
- Understanding the impact of AEs/MEs is crucial for improving patient care and safety in critical care settings.
Purpose of the Study:
- To systematically review and meta-analyze the effects of AEs/MEs on mortality.
- To examine the impact of AEs/MEs on hospital and ICU length of stay.
- To provide a quantitative synthesis of evidence regarding AEs/MEs in the ICU.
Main Methods:
- Systematic review and meta-analysis of studies identified from four major databases.
- Screening of 902 potentially eligible studies.
- Quantitative analysis of 10 selected studies meeting inclusion criteria.
Main Results:
- Patients with AEs/MEs showed a nonsignificant increase in mortality (OR=1.5, 95% CI=0.98-2.14).
- Significantly longer hospital stays were observed for patients with AEs/MEs (mean difference = 8.9 days, 95% CI=3.3-14.7).
- Patients with AEs/MEs also experienced significantly longer ICU stays (mean difference = 6.8 days, 95% CI=0.2-13.4).
Conclusions:
- The ICU environment is associated with a substantial incidence of AEs/MEs.
- Patients experiencing AEs/MEs have demonstrably worse outcomes, including prolonged hospital and ICU stays.
- These findings underscore the importance of addressing AEs/MEs to improve patient outcomes in critical care.
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