{
  "abstract": "Background Healthcare-related procedural misadventures remain underreported despite decades of investment in patient safety. International Classification of Diseases, 10th Revision (ICD-10) codes Y62–Y69 capture defined preventable adverse events during medical and surgical care. This study aimed to examine temporal patterns in Y62–Y69-coded events using aggregated, precomputed data from the TriNetX Global Collaborative Network.Methods We conducted a retrospective observational study using deidentified electronic health records from the TriNetX platform, encompassing over 135 million patients aged 0–89 (years: 2016–2024). Incidence rates for Y62–Y69–coded events were analysed globally and across four regional networks, USA, Europe–Middle East–Africa (EMEA), Asia-Pacific (APAC) and Latin America (LATAM), with additional sensitivity analyses in cardiovascular (ICD-10: I00–I99) and oncological (ICD-10: C00–D49) cohorts. Temporal trends were explored descriptively using polynomial regression (for visual pattern illustration) and the Mann-Kendall trend test.Findings Globally, Y62–Y69 incidence rates increased from 0.04 to 0.09 per 100 000 patients between 2016 and 2024 (125% increase), with inflection in the early postpandemic phase. EMEA exhibited the steepest rise (414%), followed by APAC (225%). The USA showed a non-linear pattern detectable only through polynomial modelling. LATAM and APAC trends lacked statistical significance, likely due to high year-to-year variability. Sensitivity analyses in the disease-specific cohorts reflected similar patterns, reinforcing the consistency of findings.Interpretation This is the first global, real-world analysis of ICD-10 Y62–Y69–coded adverse events. The findings reveal a notable postpandemic escalation in procedural harm, underscoring the fragility of safety systems under operational stress. Regional heterogeneity and non-linear trajectories highlight the importance of locally tailored interventions and the need to reinvigorate global patient safety efforts.Data availability statement All data were extracted from the TriNetX Global Collaborative Network. Aggregated incidence rates and the R code used for statistical analysis are provided in online supplemental file 2.",
  "authors": [
    {
      "affiliations": [
        "Department of Biomedical Sciences for Health, University of Milan, Milan, Italy",
        "Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy"
      ],
      "name": "Rosario Caruso"
    },
    {
      "affiliations": [
        "Department of Clinical and Molecular Medicine, Sapienza University of Rome, Roma, Lazio, Italy"
      ],
      "name": "Marco Di Muzio"
    },
    {
      "affiliations": [
        "Department of Medical and Movement Sciences and Wellness, University of Naples Parthenope, Naples, Campania, Italy"
      ],
      "name": "Emanuele Di Simone"
    },
    {
      "affiliations": [
        "Nursing, Technical and Rehabilitation Department - DaTeR, Azienda Unità Sanitaria Locale di Bologna, Bologna, Italy"
      ],
      "name": "Sara Dionisi"
    },
    {
      "affiliations": [
        "Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy"
      ],
      "name": "Arianna Magon"
    },
    {
      "affiliations": [
        "Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy"
      ],
      "name": "Gianluca Conte"
    },
    {
      "affiliations": [
        "Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy",
        "Centre of Excellence for Nursing Scholarship, Rome, Italy"
      ],
      "name": "Alessandro Stievano"
    },
    {
      "affiliations": [
        "Data Management, Scientific Directorate, IRCCS Policlinico San Donato, San Donato Milanese, Italy"
      ],
      "name": "Emanuele Girani"
    },
    {
      "affiliations": [
        "Data Management, Scientific Directorate, IRCCS Policlinico San Donato, San Donato Milanese, Italy"
      ],
      "name": "Sara Boveri"
    },
    {
      "affiliations": [
        "Department of Biomedical Sciences for Health, University of Milan, Milan, Italy"
      ],
      "name": "Pier Mario Perrone"
    },
    {
      "affiliations": [
        "Department of Biomedical Sciences for Health, University of Milan, Milan, Italy",
        "Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Lombardy, Italy"
      ],
      "name": "Silvana Castaldi"
    },
    {
      "affiliations": [
        "Scientific Directorate, IRCCS Policlinico San Donato, San Donato Milanese, Italy"
      ],
      "name": "Lorenzo Menicanti"
    },
    {
      "affiliations": [
        "Frances Payne Bolton School of Nursing and School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA"
      ],
      "name": "Mary Dolansky"
    }
  ],
  "title": "Retrospective analysis of preventable procedural adverse events (ICD-10 Y62–Y69) in the TriNetX network: a multiregional study before, during and after the COVID-19 pandemic",
  "uid": "edc5ea56-4ee8-5d9e-b5e1-b0cf1de31742"
}