Abstract

Background: Adverse events are unintentional injuries or complications that result in a longer hospital stay, impairment upon discharge, or death that are caused by healthcare administration rather than the patient’s underlying illness process. It is believed that patient damage caused by adverse events is one of the top ten causes of mortality and disability worldwide.

Low- and middle-income countries bear around two-thirds of the worldwide cost of adverse events caused by hazardous treatment, including the disability-adjusted life years lost as a result of them.

The incidence of adverse events has been reported to be higher in surgical specialties, being twice as common as in medical specialties. Despite this burden, there is paucity of data on its actual existence in Sub-Saharan Africa and Cameroon

Objective: Understanding these advents events at two levels of health care, assessing the use and impact of the WHO patient safety checklist on the incidence of these events, and developing strategies to prevent and reduce the incidence and impact of surgical adverse events.

Materials and methods: Over a 10-year period, a two-stage retrospective chart review was conducted at the surgical units of the Bota District and Limbe Regional Hospitals.

Medical records that were available were kept based on qualifying requirements. In the first round, eligible files were assessed for criteria for probable adverse events. A thorough medical examination was then performed to validate these occurrences, which were then collected and analyzed.

Results: A total of 6324 patient files were reviewed, 5324 from the LRH and 1000 from the BDH. Only 5035 files were eligible (4335 files in LRH and 700 files in BDH) and so were retained.

A total of 39 adverse events were recorded, with 20 (51.3%) occurring in males and 19 (48.7%) occurring in females. Of the 39 adverse events, 36 (92.31%) were operation-related, whereas 3 (7.69%) were not. General surgery patients encountered 17 (43.59%), gynecologic surgery 9 (23.08%), orthopedic surgery 6 (15.38%), and urologic surgery 4 (10.26%) of these occurrences.

The overall rate of adverse events was (39 adverse events/5035 admissions), or 0.8%, with a higher frequency (1%) in BDH. None of the surgical patients’ files had a recorded WHO safety checklist. The majority of the incidents resulted in a longer hospital stay (76.92%), with urologic patients having the greatest incidence of deaths (50%).

Conclusion: Surgical complications are prevalent, especially at lower levels of care, and have a significant impact on both the individual patient and society as a whole. The overall occurrence of these incidents remains low in our scenario; however, this may be heavily impacted by a lack of data collection systems. The influence of the WHO patient safety checklist on the occurrence of these incidents has yet to be determined because it is rarely used.

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