Prevalence of Adverse Events in Mexico Using the Institute for Healthcare Improvement—Global Trigger Tool Method: A Retrospective Study

Abstract

Rationale

Globally, adverse events (AEs) are a major contributor to mortality, often arising from healthcare management rather than patients' underlying conditions.

Aims and Objectives

This study aimed to estimate the prevalence of AEs in three different hospitals in central-north Mexico using the Institute for Healthcare Improvement Global Trigger Tool (IHI-GTT) method.

Method

A retrospective review of hospital discharges (July 2022 to June 2023) was conducted in three hospitals using the IHI-GTT method. Records of patients aged ≥ 18 years with hospital stays longer than 24 h were reviewed, with obstetric and paediatrics cases excluded. One experienced physician performed the two-stages review process, with inter-rater reliability assessed on 1% of records. Logistic regression analysis was used to identify factors associated with AEs.

Results

Among 3354 discharges, 36.6% (n = 1227) experienced at least one adverse event (AE), corresponding to 72.79 AEs per 1000 patient-days or 53.04 AEs per 100 admissions. Of these, 72.8% (n = 893) were preventable. The most frequent AEs were medication errors (23.6%), intravenous line errors (23.5%), hospital acquired infections (16.4%), and surgical (9.9%). The AEs contributed to the death of the patient in 14.6% (n = 179) of cases. Risk factors for AEs included hospital transfers (OR: 1.53; 95% CI: 1.25–1.87, p < 0.001), age ≥ 60 years (OR: 1.49; 95% CI: 1.22–1.83, p < 0.001), comorbidities (OR: 1.15; 95% CI: 1.08–1.23, p < 0.001), and longer hospital stay (OR: 1.13; 95% CI: 1.11–1.14, p < 0.001). Elective admissions showed a protective effect (OR: 0.77; 95% CI: 0.62–0.97, p = 0.027).

Conclusion

The prevalence of AEs in Mexico, a middle-income country, is higher than previously reported. These finding underscore a pressing public health challenge requiring targeted interventions.