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Death among surgical inpatients with treatable serious complications (failure to rescue)

CBE ID
0200
Endorsement Status
1.1 New or Maintenance
Previous Endorsement Cycle
Is Under Review
No
1.3 Measure Description

Percentage of surgical inpatients with complications of care whose status is death

        • 1.14 Numerator

          Surgical inpatients with complications of care whose discharge status is death

        • 1.15 Denominator

          Major surgical discharges with complications of care: sepsis (ICD-9-CM codes 038, 790.7), pneumonia (ICD-9-CM codes 507.0, 997.3, 514, 482, 485, 486), GI bleeding (ICD-9-CM codes 531.00-531.31,531.9,532.00-532.31, 532.9, 533.00-533.31,533.9, 534.00-534.31, 534.9, 535.01, 535.4, 578.9, 530.82), shock/cardiac arrest (ICD-9-CM codes 427.5, 785.5, 785.50, 785.51, 785.59, 799.1, 93.93, 99.60, 99.63), DVT/PE (ICD-9-CM codes 451.81, 451.11, 451.19, 415.11, 415.1, 453.8)

        • Exclusions

          Exclusions as noted for each complication of care :
          Sepsis excluding sepsis as a primary diagnosis, AIDS and immunocompromised states, LOS 3 days, infection related admission
          Pneumonia excluding any primary diagnosis of pneumonia, any secondary diagnosis of ICD-9-CM 480, 481, 483, 484, 487, MDC4 (respiratory system), AIDS and immunocompromised states
          GI Bleeding excluding primary GI bleed as a primary diagnosis, MDC 6 (digestive tract), MDC 7 (hepatobiliary tract and pancreas), primary diagnosis of anemia due to blood loss, trauma, burn, alcoholism
          Shock/cardiac arrest excluding shock as primary diagnosis, MDC 4 (respiratory), MDC 5 (cardiac), hemorrhage or trauma as a primary diagnosis
          DVT/PE excluding DVT/PE as a primary diagnosis and pregnancy related PE

        • Most Recent Endorsement Activity
          Measure Retired and Endorsement Removed Surgical Consensus Standards Endorsement Maintenance
          Initial Endorsement
          Last Updated
          Removal Date
        • Steward
          Agency for Healthcare Research and Quality
          Steward Organization POC Email