Outcome of adverse events and medical errors in the intensive care unit: a systematic review and meta-analysis

Am J Med Qual. 2015 Jan-Feb;30(1):23-30. doi: 10.1177/1062860613514770. Epub 2013 Dec 19.


Adverse events and medical errors (AEs/MEs) are more likely to occur in the intensive care unit (ICU). Information about the incidence and outcomes of such events is conflicting. A systematic review and meta-analysis were conducted to examine the effects of MEs/AEs on mortality and hospital and ICU lengths of stay among ICU patients. Potentially eligible studies were identified from 4 major databases. Of 902 studies screened, 12 met the inclusion criteria, 10 of which are included in the quantitative analysis. Patients with 1 or more MEs/AEs (vs no MEs/AEs) had a nonsignificant increase in mortality (odds ratio = 1.5; 95% confidence interval [CI] = 0.98-2.14) but significantly longer hospital and ICU stays; the mean difference (95% CI) was 8.9 (3.3-14.7) days for hospital stay and 6.8 (0.2-13.4) days for ICU. The ICU environment is associated with a substantial incidence of MEs/AEs, and patients with MEs/AEs have worse outcomes than those with no MEs/AEs.

Keywords: adverse events; intensive care unit; medical error; outcomes; systematic review.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Checklist
  • Hospital Mortality*
  • Humans
  • Incidence
  • Intensive Care Units / statistics & numerical data*
  • Length of Stay / statistics & numerical data*
  • Medical Errors / statistics & numerical data*
  • Patient Safety
  • Quality Indicators, Health Care / statistics & numerical data