{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T02:37:06Z","timestamp":1777862226382,"version":"3.51.4"},"reference-count":19,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2011,7,1]],"date-time":"2011-07-01T00:00:00Z","timestamp":1309478400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J R Soc Med"],"published-print":{"date-parts":[[2011,7]]},"abstract":"\n Objectives<\/jats:title>\n To estimate incidence of injury to patients attributed to misadventures during surgical and medical care by age group and to examine recent trends.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Analysis of routine morbidity and mortality data categorized by the 9th and 10th revisions of the International Classification of Diseases.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n Children 0\u201314 years and adults \u226515 years.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n England and Wales during 1999 to 2008 (hospital episodes) and 1979 to 2009 (deaths).<\/jats:p>\n <\/jats:sec>\n \n Main outcome measures<\/jats:title>\n We calculated deaths per million person-years and per 1000 hospital episodes; hospital episodes per 100,000 person-years and per 100,000 procedures performed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The rate of death attributed to misadventures during surgical and medical care in patients aged 75 years and older was over 50 times (rate ratio 57.2; 95% confidence interval 38.3\u201385.3) higher than in children aged 1\u201314 years. Estimated hospital episode rates were 20 times (RR 20.0; 18.9\u201321.2) higher in patients aged 75 years and older. Mortality attributed to misadventures declined from 1.1 (0.9\u20131.4) deaths per million person-years in 1979 to 0.4 (0.2\u20130.6) in 2009. Hospital episodes of misadventures decreased between 1999 and 2008 from 30.8 (29.9\u201331.8) episodes per 100,000 procedures to 23.25 (22.5\u201324.1), but increased from 7.8 (7.6\u20138.1) per 100,000 person-years to 9.8 (9.5\u201310.1).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Misadventures during surgical and medical care are an important cause of avoidable injury. Older patients appear to be at higher risk of experiencing and dying from misadventure. Interpretation of recent trends is limited by uncertainties regarding the consistency and coverage of coding.<\/jats:p>\n <\/jats:sec>","DOI":"10.1258\/jrsm.2011.100408","type":"journal-article","created":{"date-parts":[[2011,7,4]],"date-time":"2011-07-04T07:23:54Z","timestamp":1309764234000},"page":"292-298","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Misadventures to patients during surgical and medical care in England and Wales: an analysis of deaths and hospital episodes"],"prefix":"10.1258","volume":"104","author":[{"given":"Katharine","family":"Ker","sequence":"first","affiliation":[{"name":"Department of Nutrition & Public Health Intervention Research, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phil","family":"Edwards","sequence":"additional","affiliation":[{"name":"Department of Nutrition & Public Health Intervention Research, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian","family":"Roberts","sequence":"additional","affiliation":[{"name":"Department of Nutrition & Public Health Intervention Research, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2011,7,3]]},"reference":[{"key":"bibr-JRSM-10-0408C1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.322.7285.517"},{"key":"bibr-JRSM-10-0408C2","unstructured":"NHS Litigation Authority.\n Factsheet 2: financial information.\n London: NHSLA, 2010. See http:\/\/www.nhsla.com\/home.htm"},{"key":"bibr-JRSM-10-0408C3","volume-title":"National Reporting and Learning Service","author":"National Patient Safety Agency","year":"2009"},{"key":"bibr-JRSM-10-0408C4","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.a1702"},{"key":"bibr-JRSM-10-0408C5","volume":"329","author":"Aylin P","year":"2004","journal-title":"BMJ"},{"key":"bibr-JRSM-10-0408C6","volume-title":"Twentieth Century Mortality \u2013 100 years of mortality data in England & Wales by age, sex, year and underlying cause. CD-ROM","author":"Office for National Statistics"},{"key":"bibr-JRSM-10-0408C7","unstructured":"Office for National Statistics.\n Publication Hub \u2013 Gateway to UK National Statistics. DR Series 2000\u20132009.\n London: UK Statistics Authority . See http:\/\/www.statistics.gov.uk\/"},{"key":"bibr-JRSM-10-0408C8","unstructured":"HESonline.\n Hospital Episode Statistics.\n See http:\/\/www.hesonline.nhs.uk\/"},{"key":"bibr-JRSM-10-0408C9","unstructured":"PEDW Data Online.\n Patient Episode Database for Wales.\n See http:\/\/www.infoandstats.wales.nhs.uk\/"},{"key":"bibr-JRSM-10-0408C10","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a114731"},{"key":"bibr-JRSM-10-0408C11","volume-title":"An Organisation with a Memory","author":"Department of Health","year":"2000"},{"key":"bibr-JRSM-10-0408C12","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2006.065573"},{"key":"bibr-JRSM-10-0408C13","unstructured":"HESonline.\n Topics paper \u2013 External Causes.\n See http:\/\/www.hesonline.nhs.uk\/Ease\/servlet\/ContentServer?siteID=1937&categoryID=1260"},{"key":"bibr-JRSM-10-0408C14","doi-asserted-by":"publisher","DOI":"10.1001\/jama.286.6.708"},{"key":"bibr-JRSM-10-0408C15","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2003.08.010"},{"key":"bibr-JRSM-10-0408C16","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.321.7267.992"},{"key":"bibr-JRSM-10-0408C17","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa044464"},{"key":"bibr-JRSM-10-0408C18","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6603709"},{"key":"bibr-JRSM-10-0408C19","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(02)01531-0"}],"container-title":["Journal of the Royal Society of Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1258\/jrsm.2011.100408","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1258\/jrsm.2011.100408","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1258\/jrsm.2011.100408","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T05:08:46Z","timestamp":1777525726000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1258\/jrsm.2011.100408"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,7]]},"references-count":19,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2011,7]]}},"alternative-id":["10.1258\/jrsm.2011.100408"],"URL":"https:\/\/doi.org\/10.1258\/jrsm.2011.100408","relation":{},"ISSN":["0141-0768","1758-1095"],"issn-type":[{"value":"0141-0768","type":"print"},{"value":"1758-1095","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,7]]}}}