A decade-long overview of adverse events in a tertiary surgical service in South Africa.

Background: Adverse events are common, and impact patients and healthcare systems negatively. Large international systems investigate adverse events at length, but South African data are lacking.

Objectives: To classify all adverse events that have occurred in our department over the last decade.

Methods: Ten years of data from a prospectively collated electronic medical record system were analysed for adverse events. All admitted patients were included. Duplicate entries and those that did not describe adverse events were excluded.

Results: The study period was from December 2012 to January 2023. There were 52 835 distinct admissions covering 321 385 inpatient days. After categorisation, a total of 14 537 adverse events were captured, giving an adverse event rate of 22%. Adverse events were categorised into four groups. Of the total, 8 027 events were clinical care related, 3 106 were pathology related, 2 662 were system related and 442 miscellaneous. A total of 300 were excluded. Clinical care-related adverse events comprised 57.3% of the total number. Of those, adverse events related to indwelling devices (32.4%), iatrogenic injuries (12.5%) and intravenous therapy administration (12.5%) contributed most. Pathology-related adverse events contributed 21.4% of the total, of which wound sepsis (29.5%), anastomotic leak (15.1%) and nosocomial pneumonia (14.4%) were the most common. There was a general downward trend in reported adverse events from 2016 to 2022.

Conclusion: Adverse events are common, and their aetiology is multifactorial. A sustained and multi-faceted approach is needed to address the challenge they pose.