Impact of patient safety on hospital prognosis: Association between adverse events and in-hospital mortalit
| Title: | Impact of patient safety on hospital prognosis: Association between adverse events and in-hospital mortalit |
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| Authors: | Miriam Roncal-Redin; Diego San Jose-Saras; Cristina Díaz-Agero Pérez; Jorge Vicente-Guijarro; Paloma Moreno-Nunez; Alberto Pardo-Hernandez; Jesus María Aranaz-Andrés; José Lorenzo Valencia Martín; Asunción Colomer Rosas; Inmaculada Mediavilla Herrera; Mª José Esteban Niveiro; Nieves López Fresneña; Pedro Ruiz Lopez; Isabel Carrasco Gonzalez; Cristina Navarro Royo; Carmen Albéniz Lizarraga; Yuri Fabiola Villan; Ana Isabel Alguacil Pau; Alicia Díaz Redondo; Rosa Plá Mestre; Dolores Martín Ríos; Angels Figuerola Tejerina; Carlos Aibar Remón; José Joaquín Mira Solves; Idelfonso González Solana; Montserrat Salcero Guijarro; Delia Fernández Redondo; Esteban del Pozo García; Cornelia Bischofberger Valdés; Libertad Martín Prieto; Marta Grande Arnesto; Beatriz Nieto Pereda; Ana Herranz Alonso; Laura Rubio Cirilo; Rafael Martos Martínez; María Teresa Ledo Varela; María Vicenta García Rosado; Jesús Minaya Saíz; María Jesús Labrador Domínguez; María José Pita López; Elia Mayoral Peccis; Marco Antonio Espinel Ruíz; Ana Polo Parada; Emely García Carrasco; Carlos Aranda Cosgaya; Carmen Gutiérrez Bezón; María de Sebastián Rueda; Miguel Ruíz Álvarez; Mercedes Vinuesa Sebastián; María Dolors Montserrat Capella; Carolina Ruíz Entrecanales; Sonia de Miguel Fernández; María Pilar González Sánchez; Felisa Jaén Herreros; María José Durá Jiménez; Carmen de Burgos Lunar; Anabel Alguacil Pau; María Ángel Valcárcel de la Iglesia; Laura Moratilla Monzó; Mercedes Ortiz Otero; Margarita Mosquera González; Susana Lorenzo Martínez; María Dolores Martín Ríos; Carolina Lucas Molina; María Teresa Sayalero Martín; María Dolores Calles Gato; Juan José Granizo Martínez; Juan Vega Barea; Eva Jiménez González de Buitrago; Inés Fernández Jiménez; Cristina García Fernández; Inmaculada López Carrillo; Ana Robustillo Rodela; Elena Ramírez García; Romina Sánchez Gómez; Nieves Franco Garrobo; Nieves Plana Farrá; Marta Macías Maroto; Marta Soler Vigil; Gonzalo de las Casas Cámara; Nuria Gálvez Carranza; Ana Belén Jiménez Muñoz; Belén Martínez Mondéjar; Beatriz Isidoro Fernández; Lourdes Sainz de los Terreros Soler; Car Olina del Valle Giráldez García; Ruth González Ferrer; Guillermo Ordóñez León; Miguel Miró Murillo; Rosalía Hernández Holgado; Pilar Paloma Blanco Hernández; José Manuel Carrascosa Bernaldez; Sonia Fraile Gil; Beatriz Fidalgo Hermida |
| Source: | Clinical Medicine, Vol 26, Iss 1, Pp 100546- (2026) |
| Publisher Information: | Elsevier |
| Publication Year: | 2026 |
| Collection: | Directory of Open Access Journals: DOAJ Articles |
| Subject Terms: | Patient safety; Adverse events; In-hospital mortality; Health care; Medicine |
| Description: | Introduction: Adverse events (AEs) involve a safety problem and compromise the quality of care, but evidence on how they affect the prognosis of patients is limited. Objective: In this study, the relationship between the presence of AEs and in-hospital mortality among patients is analysed, and their characteristics are compared. Material and methods: An observational study with a cross-sectional design was conducted in 32 hospitals of varying complexity in the Community of Madrid. The clinical history of 9,111 patients was analysed. Patients who were in the emergency room and those admitted to psychiatric units or centres were excluded. All hospitalisations were reviewed using the Harvard Medical Practice Study methodology for the detection and characterisation of AEs. The association between in-hospital mortality and the number of AEs was analysed with two multivariate models via logistic regression: 1) an explanatory model adjusted for confounders and 2) a predictive model of in-hospital mortality. A descriptive analysis of the differential characteristics of the AE was performed for the patients who died. Results: In-hospital mortality was 5%, with a higher incidence of AEs in patients who died (29.8% versus 11.9%; p < 0.005). The presence of 1 AE (OR [95% CI]: 2.1 [1.6 to 2.7]) or ≥3 AEs (2.4 [1.1 to 5.1]) significantly increased the odds of mortality. In addition, the increase in the number of AEs was a predictor of mortality without a dose–response effect. The AEs that were most associated with in-hospital mortality were those related to care (15.5%; p = 0.047), and 15.3% of the AEs that occurred during ward care contributed to in-hospital mortality. Conclusion: There is an association between AEs and in-hospital mortality. The presence of at least 1 AE implies a critical event in the patient’s prognosis without a dose–response effect. Reducing AEs related to care in patients with comorbidities is positioned as an efficient strategy for improving health outcomes. |
| Document Type: | article in journal/newspaper |
| Language: | English |
| Relation: | http://www.sciencedirect.com/science/article/pii/S1470211825002647; https://doaj.org/toc/1470-2118; https://doaj.org/article/f8a64a84535848648f01ab4859621538 |
| DOI: | 10.1016/j.clinme.2025.100546 |
| Availability: | https://doi.org/10.1016/j.clinme.2025.100546; https://doaj.org/article/f8a64a84535848648f01ab4859621538 |
| Accession Number: | edsbas.98759552 |
| Database: | BASE |