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This again is related to differences in departments to which the patient was admitted between the two groups. There are a number of preventable AE types that occur rarely in patients discharged alive and are found in inpatient deaths, for example, aspiration or sepsis/bacteraemia. Discussion Main findings Inpatient deaths differ in patient and admission characteristics from patients discharged alive. Patients who died in hospital are on average older, have had a longer length of stay and are more often urgently admitted. Additionally, the department to which the patient was admitted differs between the two groups; for inpatient deaths this is less often a surgical department such as general surgery, orthopaedics, or urology. The number of AEs and preventable AEs differ, occurring at least twice as often in inpatient #CYTH4 randurls[1|1|,|CHEM1|]# deaths. There are also differences in distribution of the clinical processes related to the AE and type of AEs. Consistent with fewer admissions to a surgical department, preventable AEs in inpatient deaths were proportionally less often related to the surgical process. A few AEs occur rarely in patients discharged alive: sepsis/bacteraemia and aspiration, and this is most likely because these outcomes often lead to a patient's death. No specific type of preventable AE present in patients discharged alive was absent in deceased patients. Implications for practice, policy and research Patient record review used in large national AE studies, or in hospitals as a part of the quality and safety cycle, are often performed, but are also very costly projects. It is important to know if efficiency can be improved by exclusively sampling or oversampling inpatient deaths. We found that exclusively sampling or oversampling inpatient deaths does seem to be an efficient method: fewer patient records need to be studied to identify where safety improvements are possible; especially when the goal is not specifically the estimation of incidences for the total hospital population, but primarily to obtain as much information as possible on patient safety threats and potential solutions, this seems to be an efficient choice as fewer patient records are required to find one preventable AE. This goal is most likely the case for individual hospitals performing chart review as part of their quality and safety improvement cycle. In this case, the results of a structured review of complete patient admissions provide information on improvement possibilities specific for that hospital. The results are often discussed in morbidity and mortality meetings, where additional information on the preventable AEs can be acquired from the involved physicians and nurses. This also may contribute to raising a shared sense of urgency and commitment to improvement. A focus on reviews of deaths is likely to promote interest in the measurement of preventable deaths and perhaps even differences between organisations.