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

## TL;DR

This study found a high rate of preventable adverse events in Mexican hospitals, highlighting a major public health issue.

## Contribution

The study provides new prevalence data on adverse events in Mexico using a standardized global method.

## Key findings

- 36.6% of hospital discharges experienced at least one adverse event.
- Medication errors and intravenous line errors were the most frequent preventable adverse events.
- Hospital transfers and older age were significant risk factors for adverse events.

## Abstract

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

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.

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.

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).

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.