Adverse Events in Hospitalized Children Are Preventable

A study by researchers at Northwestern University Feinberg School of Medicine suggests that nearly 70,000 children hospitalized in the United States experience an adverse event each year and that at least 60 percent of these errors may be preventable.

Adverse events are injuries caused by medical management rather than diseases that result in either prolonged hospitalization or disability at discharge, according to the study, which appeared in the January issue of the journal Pediatrics.

Donna Woods, a post-doctoral fellow in the Institute for Health Services Research and Policy Studies at Feinberg, and colleagues used data from the Colorado and Utah Medical Practice Study to analyze the incidence and types of adverse events occurring in hospitalized children. These same data were used by the Institute of Medicine to determine how frequently medical errors occur in the United States. The study provides an equivalent assessment for children.

The data were derived from the records of over 3,700 hospital patients from newborns to 20-year-olds. The researchers compared these data with information from adult patients aged 21 to 65 years.

Results showed that 1 out of every 100 patients experienced an adverse event. Preventable adverse events rates were 0.5 percent in newborns and infants; 0.22 percent in children aged 1 to 12 years; and 0.95 percent in adolescents aged 13 to 20 years. The rate in the adult group was 1.5 percent.

Of preventable adverse event types, the most common were birth-related (over 32 percent) and diagnostic-related (over 30 percent). These were significantly more common than surgically related preventable adverse events (3.5 percent).

The findings from the study support the notion that “adverse event risk for children differs significantly from that of adults and suggests that processes, mechanisms and systems that lead to adverse events for children may differ significantly from those for adults,” Woods said.

She further recommended that research to reduce adverse events in hospitalized children should focus on adolescent hospitalized patients, birth-related medical care and diagnostics in pediatrics.

Woods’s co-authors were Jane Holl, M.D., assistant professor of pediatrics at Feinberg, and researchers from the University of Texas-Huston; Brandeis University; and Harvard Medical School. The research was supported by an AHRQ Institutional National Research Service Award.

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