The identification of adverse events in hip-fracture patients using the Global Trigger Tool: A prospective observational cohort study

Abstract Introduction Hip fracture is common in the elderly and is associated with high comorbidity, mortality and complication rate. There has been an increase in the investigation of healthcare-related adverse events (AEs) in some patient groups but there is limited knowledge about hip-fracture patients. The aim was to explore the incidence, preventability and nature of AEs in hip-fracture patients. Methods 163 hip-fracture patients participated. A record review was conducted on prospectively collected data using Global Trigger Tool methodology to identify AEs up to 90 days after surgery. Results 62 (38%) of 163 patients had at least one AE (range 1–7). 102 AEs were identified and 62 (60.8%) were deemed preventable. Healthcare-associated infections e.g. pneumonia, urinary tract infections and pressure ulcers were common. AEs were more common in older patients and those with pre-existing health conditions. 58 (56.9%) AEs caused temporary harm and 4 (3.9%) contributed to patient death. Conclusion AEs are common in hip-fracture patients and a majority are preventable. If the focus is on improving healthcare for these patients, we should be concentrating our efforts on reducing the number of these preventable AEs, with a particular emphasis on improving the care of older patients with pre-existing health conditions.