[Safety of patients and adverse events related thereto in medicine]. / Bezopasnost' patsientov i sviazannye s nei neblagopriiatnye sobytiia v meditsine.

The article deals with the analysis of retrospective and prospective studies dedicated to examining patient safety regarding epidemiology, frequency and severity of adverse events associated with rendering medical care. Electronic retrieval was carried out over the period from 1990 to 2017 using the following databases: MEDLINE, Cochrane Collaboration, EMBASE, SCOPUS, ISI Web of Science. The carried out meta-analysis made it possible to determine that cases of doing harm (adverse events) while rendering medical care are registered in 10.6% of patients. More than 80% of adverse events occur in hospital, with more than half of them revealed in the operating room and about third in a patient ward. While rendering medical care outside hospital, more often cases of doing harm are observed due to medical errors made in the physician's office and due to the patient's behaviour at home. The majority of adverse events appeared to be associated with performing an operation, manipulation, carrying out drug therapy, late or inappropriate treatment and diagnosis. Unexpected death secondary to unfavourable events is observed in 5.3% of patients. In the structure of in-hospital mortality, the proportion of deaths associated with rendering medical care accounts for 24.9% and in the structure of overall population mortality - for 9.7%, ranking third amongst all causes.