Adverse patient occurrences in otorhinolaryngology: Results of a systematic registry in a tertiary referral hospital

OBJECTIVE: To identify patient groups at risk for Adverse Patient Occurrences (APOs) to improve the quality of care. STUDY DESIGN: This study was conducted using retrospective analysis. METHODS: APOs have been systematically registered from 1997 to 2006 in all patients (6,932) admitted to the otorhinolaryngology-head and neck surgery department of the University Hospital Maastricht, the Netherlands. Several characteristics such as length of stay, age, gender, season, and diagnosis were related to the incidence and type of APOs. RESULTS: Increasing age and length of stay are related to an increasing incidence of APOs. Children are found to be at high risk too and outpatient treatment (<24 h) is a risk factor for APOs. Of all APOs, 67% were organizational and 33% medical. The three diagnosis-related groups (DRGs), in which APOs occurred most, were the inner ear/cerebellopontine angle (CPA), esophagus, and head and neck oncology group. No seasonal influences on APO occurrences existed. CONCLUSIONS: Male and female patients >60 or <10 years old are at the highest risk for APOs. Their risk increases with their length of stay and is high when admitted less than 24 hours. When patients are among the three most prevalent DRGs, their risk is even higher.