Increased Mortality and Costs Associated with Adverse Events in Intensive Care Unit Patients

Abstract

Background: Adverse events (AEs) are defined as unintended complications occurring to patients as a result of medical care. AEs are especially prevalent in the intensive care unit (ICU) setting and may lead to negative patient outcomes. Although many studies have examined the impact of AEs on patient outcomes, few have investigated their associated costs. Methods: The study population consisted of 17 173 adult patients (≥18 years of age) who were admitted to the ICU at The Ottawa Hospital (TOH) between 2011 and 2016. AEs were categorized using an established International Classification of Diseases 10th revision (ICD-10) patient safety indicators (PSI) system for AE detection. Logistic regression was performed to determine the association between AEs and in-hospital outcomes, including mortality. In addition, we constructed a generalized linear model to assess the independent association between AEs and total hospital costs. Results: Patients who experienced an AE had longer total hospital and ICU lengths of stay, required more invasive ICU interventions, had more complex discharge plans, and experienced higher rates of in-hospital mortality compared to those who did not experience an AE. Average total hospital costs and ICU-specific costs were higher among patients who experienced an AE ($72 718; $46 715) relative to their counterparts ($20 543; $16 217), but the per day cost was comparable in both groups. After controlling for age, sex, patient comorbidities, and illness severity, AEs were significantly associated with an increased odds of mortality (OR = 1.13, 95% CIs = 1.04, 1.22) and total average costs (Cost Ratio = 1.04, 95% CIs = 1.06, 1.08). The most impactful AE subtypes from a cost- and patient-perspective were hospital-acquired infections (HAI) and cardiac-related AEs. Conclusion: Incidence of AEs among ICU patients is associated with higher patient mortality and elevated costs. Specific causes of these AEs should be investigated, with further protocols and interventions developed to reduce their occurrence.

Standardized Solutions of Catecholamines in Intensive Care Medicine: Application, Safety and Economic Aspects

“…The rate of adverse events in the ICU is reported in various studies to be more than 30%. Corresponding patient harm must be urgently avoided and, if not, may cause considerable follow-up costs in the range of USD 37,000 per case [ 7 ].…”

Nurses’ Intentions, Awareness and Barriers in Reporting Adverse Events: A Cross-Sectional Survey in Tertiary Hospitals in China

“… 13 Adverse events in nursing are any nursing-related events such as patient falls, wandering, injuries, suicides, bed sores, medication errors, and nursing-related hospital infections. 14 Clinical evidence shows that more than 50% of nurses have experienced an adverse event, 15 , 16 which not only increases patient mortality and costs 17 but also has a negative impact on nurses’ physical and mental well-being. 18 Murphy et al estimated the annual economic cost of nurse-sensitive adverse events to be $92.26 million for the Irish health service.…”

No-Touch Automated Disinfection System Based on Hydrogen Peroxide and Ethyl Alcohol Aerosols for Use in Healthcare Environments

“…Hospital-acquired infections (HAIs) are a worldwide public health problem [1] and a significant cause of morbidity and mortality [2][3][4][5][6][7][8][9][10]. Even though standard decontamination procedures are insufficient, they still represent the main means of intervention to counter the circulation of pathogenic or potentially pathogenic microorganisms, and reduce infectious complications [11][12][13][14].…”