More Than One-Third of Patients Admitted Into Hospitals for Surgeries Experience Adverse Health Events: Study

Although a new study suggests that nearly 40% of all patients undergoing surgery experience adverse health complications, researchers indicate that the vast majority of the problems could be avoided if medical staff take the correct and appropriate steps to protect patients.

Adverse surgical events can include surgical site infections, patients experiencing threatening events while under anesthesia, and dangerous situations like low or high blood pressure during the procedure.

In findings published last week in the medical journal The BMJ, researchers from Harvard Medical School and Brigham and Women’s Hospital indicate that more than one-third of patients who are admitted to hospitals for surgery suffer some type of adverse event, usually related to the surgical procedure they underwent.

For the study, a team of researchers, led by Dr. Antoine Duclos, looked for instances of adverse events among 64,000 adults admitted for surgery at 11 hospitals across the United States in 2018.

The researchers determined that 38% of all surgical patients in the data set suffered some type of adverse complication from surgery, with major adverse events that could have caused serious harm occurring in nearly 16% of patients. Complications were classified as an event that could cause serious harm if it required substantial doctor intervention, prolonged patient recovery, a life-threatening event or death.

The data indicates that the most common adverse events patients experienced were related to the surgical procedures they underwent, such as the incisions, and side effects from medications, like allergic reactions.

Researchers said that they believe 60% of the complications may have been preventable, and another 21% definitely could have been avoided if the proper standards of care had been followed. They warn that this calls into question many of the common medical practices at hospitals throughout the U.S.

The researchers report that 49% of in-patient adverse events were linked directly to the surgery. This includes complications with the incision and side effects occurring during surgery. However, only about 25% of adverse events occurred while the patient was in the operating room. More than half of the problems occurred in the general care unit, and 13% occurred in intensive care units (ICU).

Medications that doctors gave to the patients were responsible for 27% of adverse events, while an additional 12% were due to hospital-acquired infections, 11% were linked to patient care, and less than 1% were from blood transfusion reactions.

The hospital staff that were most commonly involved in surgical complications were the primary attending physician, the researchers determined. The attending physician was involved in more than 90% of reported adverse events.

Duclos’s team concluded there is a “critical need” for steps to be taken to improve patient care across all surgical staff members, including the surgeons, nurses and advanced specialist doctors.

“Adverse events were identified in more than one third of patients admitted to hospital for surgery, with nearly half of the events classified as major and most potentially preventable,” they wrote. “These findings emphasize the critical need for ongoing improvement in patient safety, involving all health professionals, throughout perioperative care.”

The findings are an update to a landmark Harvard study conducted in the 1980s, which looked at the rate of incidence and preventability of adverse events during hospital care. That report found that nearly half of such complications were linked to surgical procedures.

The data from that report aided in the creation of a U.S. National Academy of Medicine’s “To Err is Human” report in 2000, which kicked off worldwide efforts to improve patient safety.