Assessment of the occurrence of adverse events through the global trigger tool in a university hospital in Italy

The reporting of adverse events (AEs) through incident reporting (IR) is considered a valuable tool to ensure their analysis. In addition, the Global Trigger Tool (GTT) methodologies allow a review of clinical records through triggers. The purposes of this study were to assess the occurrence, type and severity of AEs detected by the GTT, comparing the results with the IR system. A retrospective study was conducted between September and November 2023 in Italy on 500 clinical records of patients admitted in 2022 and 2023. A total of 59 AEs were detected in 45 patients (11.8%), and all were associated with at least one trigger. The most frequent AEs were healthcare-associated infections (HAI) (32.2%), medication (27.1%), procedures (23.7%), and healthcare-related AEs (17%). Only 3.4% of the AEs revealed by GTT were also reported in the IR system. Male sex, higher Charlson index, and length of stay were significantly associated with higher results of AE. Significant predictors of in-hospital death were permanence in intensive care units and exposure to central venous catheter. The GTT demonstrated to be feasible and to provide a broader evaluation of the pattern of AEs in the hospital. The findings suggest the need to rely on multiple data sources and methodologies to identify AEs.