Incidence, preventability and consequences of adverse events in older people: results of a retrospective case-note review

Age Ageing. 2008 May;37(3):265-9. doi: 10.1093/ageing/afn043. Epub 2008 Mar 10.


Objectives: to estimate the extent, preventability and consequences of adverse clinical events in elderly and non-elderly patients.

Design: a two-stage structured, retrospective, patient case-note review.

Setting: a large NHS hospital in England.

Population: a random sample of 1,006 non-psychiatric patients.

Main outcome measures: proportion of patients with adverse events, the proportion of preventable adverse events and the types and consequences of adverse events in patients >or=75 and under 75 years old.

Results: forty five [13.5%; 95% confidence interval (CI) 10-17] of 332 patients >or=75 years and 42 (6.2%; 95% CI 4-8) of 674 patients <75 years had at least one adverse event. There was a significantly raised risk of experiencing an adverse event with increasing age [odds ratio (OR) = 1.03 adverse events per year of life, P < 0.001]. There was no statistically significant difference in preventability of adverse events and also in experiencing disability or death as a result of an adverse event by age after adjustment for potential confounders.

Conclusion: adverse events are significantly more common in non-psychiatric elderly inpatients than younger patients. There is little evidence that adverse events in older patients are more preventable and lead to disability or death more frequently.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accident Prevention
  • Accidental Falls / prevention & control
  • Accidental Falls / statistics & numerical data*
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Cross Infection / epidemiology*
  • Cross Infection / mortality
  • Cross Infection / physiopathology
  • Cross Infection / prevention & control
  • Disabled Persons
  • Drug-Related Side Effects and Adverse Reactions*
  • Humans
  • Incidence
  • Inpatients / statistics & numerical data*
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / prevention & control
  • Pressure Ulcer / epidemiology*
  • Pressure Ulcer / mortality
  • Pressure Ulcer / physiopathology
  • Pressure Ulcer / prevention & control
  • Retrospective Studies