ArticleBMJ open quality2019
Contribution of adverse events to death of hospitalised patients.
Article in BMJ open quality, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Variation in detected adverse events using trigger tools: A systematic review and meta-analysis.PloS one · 2022Pooled it
- Influence of Burnout on Patient Safety: Systematic Review and Meta-Analysis.Medicina (Kaunas, Lithuania) · 2019Pooled it
- Adverse events as key risk factors for in-hospital mortality in intensive care units.Critical care (London, England) · 2026Observational
- Pharmacokinetics and Drug Interactions.Pharmaceutics · 2026Article
- Impact of patient safety on hospital prognosis: Association between adverse events and in-hospital mortalit.Clinical medicine (London, England) · 2026Observational
- Cancer-related deaths among cases referred for forensic evaluation in Türkiye: a 5-year retrospective analysis.Revista da Associacao Medica Brasileira (1992) · 2026Article
- Mortality in orthopedic patients: a retrospective review of 333 medical records.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Poor quality care in healthcare settings: an overlooked epidemic.Frontiers in public health · 2025Review
- Establishing a trigger tool based on global trigger tools to identify adverse drug events in obstetric inpatients in China.BMC health services research · 2024Review
- Feelings of being a second victim among Spanish midwives and obstetricians.Nursing open · 2022Observational
- Educational Gradients Behind Medical Adverse Event Deaths in the US-A Time Series Analysis of Nationwide Mortality Data 2010-2019.Frontiers in public health · 2022Article
- Using the Global Trigger Tool in surgical and neurosurgical patients: A feasibility study.PloS one · 2022Article
- Fatal Events Associated with Adverse Drug Reactions in the Korean National Pharmacovigilance Database.Journal of personalized medicine · 2021Article
- Comparing the dangers of a stay in English and German hospitals for high-need patients.Health services research · 2021Article
- Factors Associated with In-Hospital Mortality in Acute Care Hospital Settings: A Prospective Observational Study.International journal of environmental research and public health · 2020Observational
- Structured Chart Review: Assessment of a Structured Chart Review Methodology.Hospital pediatrics · 2020Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: There is no standardised method to investigate death as a patient safety indicator and we need valid and reliable measurements to use adverse events contributing to death as a quality measure. Objective: To investigate the contribution of severe adverse events to death in hospitalised patients and clarify methodological differences using the Global Trigger Tool method on all inpatient deaths compared with a sample of general hospitalised patients. Method: Retrospective records reviewing using the Global Trigger Tool method. Results: In 0.3% of hospital admissions, adverse events contribute to inpatient death. Patients who die in hospital have twice the rate of adverse events per 1000 patient days compared with general patients, 76.7 vs 36.5 (p<0.001, RR 2.10, 95% CI 1.79 to 2.47). Patients dying in hospital experience seven times the rate of severe adverse events, 38.4% vs 5.2% (p<0.001, RR 2.10, 95% CI 1.79 to 2.47). For 86 out of 377 inpatient deaths, the adverse event is so severe that it contributes to death. 27.9% of severe adverse events contributing to death originate in primary care. Lower respiratory infections (p<0.001, RR 2.81, 95% CI 1.76 to 4.51), medication harm (p<0.001, RR 5.21, 95% CI 3.04 to 8.94) and pressure ulcers (p=0.04, RR 2.23, 95% CI 1.03 to 4.85) are significantly more frequent for inpatient deaths than in the general sample of hospital patients. Conclusions: Patients dying in hospitals experience seven times the rate of severe adverse events. Reviewing all inpatient death by the Global Trigger Tool method discloses new valid and reliable data of severe adverse events contributing to death which otherwise would be undetected.
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