Adverse events in five surgical procedures

Purpose The purpose of this study is to measure the adverse event rates for five elective surgical procedures: transurethral resection of prostate, cholecystectomy, hysterectomy, joint arthroplasty, and herniorrhaphy. Design/methodology/approach A retrospective two‐stage medical record review was conducted on 1,177 admissions in 1998 and 2000 at two tertiary hospitals. Records found to be positive for any of 17 screening criteria during the first stage were reviewed by surgeons from the relevant specialty for adverse events associated with the admissions. Findings The adverse event (AE) rate overall was 23.1 per cent. There were large variations between the procedural groups, ranging from 12.7 per cent (laparoscopic cholecystectomy) to 44.8 per cent (abdominal hysterectomy). Of the 272 AEs, 89 (32.7 per cent) had an unplanned readmission requiring 709 additional days in hospital and 55 (20.2 per cent) patients had additional surgery (seven returned to theatre during their admission for the procedure). AEs involving a disability that resolved within 12 months occurred for 91.2 per cent, 6.3 per cent had permanent disability, and 2.5 per cent resulted in death. The surgical reviewers determined that 24.7 per cent of the AEs were highly preventable. Originality/value The study confirms that surgical admissions have a high risk for AEs. The risk varies between procedural groups and 47.3 per cent are not preventable. Adverse events are an important patient safety issue. Preventing AEs would reduce readmissions, patient discomfort and associated costs. Routine monitoring of AEs is recommended.