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The advent of fibrinolytic therapy for acute stroke has provoked greater attention to the efficacy and quality of stroke care. Relatively less attention has been focused on safety in acute-stroke care — specifically, on adverse events related to medical errors.
Researchers retrospectively reviewed 1440 stroke admissions (81% ischemic, 19% hemorrhagic) to a tertiary-care academic hospital from July 2001 through December 2004. They analyzed 201 provider-reported adverse events in 173 patients (12%).
The study’s event review team, which included a neurologist with stroke expertise, classified 18 (9%) of the reported events as near misses and 183 (91%) as actual adverse events. The 86 actual events (47%) that were deemed to be preventable involve…