In-hospital deaths per 1,000 surgical discharges, among patients ages 18 through 89 years or obstetric patients, with serious treatable complications (shock/cardiac arrest, sepsis, pneumonia, deep vein thrombosis/ pulmonary embolism or gastrointestinal hemorrhage/acute ulcer). Includes metrics for the number of discharges for each type of complication. Excludes cases transferred to an acute care facility. A risk-adjusted rate is available. The risk-adjusted rate of PSI 04 relies on stratum-specific risk models. The stratum-specific models are combined to calculate an overall risk-adjusted rate.
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1.5 Measure Type1.7 Electronic Clinical Quality Measure (eCQM)1.8 Level Of Analysis1.9 Care Setting1.20 Testing Data Sources
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1.14 Numerator
Number of deaths (DISP=20) among cases meeting the inclusion and exclusion rules for the denominator.
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1.15 Denominator
Surgical discharges, for patients ages 18 through 89 years or MDC 14 (pregnancy, childbirth, and puerperium), with all of the following:
• any-listed ICD-9-CM or ICD-10-PCS procedure codes for an operating room procedure; and
• the principal procedure occurring within 2 days of admission or an admission type of elective (ATYPE=3); and
• meet the inclusion and exclusion criteria for STRATUM_SHOCK (shock or cardiac arrest), STRATUM_SEPSIS (sepsis), STRATUM_PNEUMONIA (pneumonia), STRATUM_DVT (deep vein thrombosis or pulmonary embolism), or STRATUM_GI_HEM (gastrointestinal hemorrhage or acute ulcer)
STRATUM_SHOCK (shock or cardiac arrest)
• any secondary ICD-9-CM or ICD-10-CM diagnosis codes or any-listed ICD-9-CM or ICD-10-PCS procedure codes for shock or cardiac arrest
STRATUM_SEPSIS (sepsis)
• any secondary ICD-9-CM or ICD-10-CM diagnosis codes for sepsis.
STRATUM_PNEUMONIA (pneumonia)
• any secondary ICD-9-CM or ICD-10-CM diagnosis codes for pneumonia or pneumonitis.
STRATUM_DVT (deep vein thrombosis or pulmonary embolism)
• any secondary ICD-9-CM or ICD-10-CM diagnosis codes for deep vein thrombosis or pulmonary embolism.
STRATUM_GI_HEM (gastrointestinal hemorrhage or acute ulcer)
• any secondary ICD-9-CM or ICD-10-CM diagnosis codes for gastrointestinal hemorrhage or acute ulcer.
Surgical discharges are defined by specific MS-DRG codes and ICD-9-CM/ICD-10-PCS codes indicating “major operating room procedures.”
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Exclusions
Exclude cases:
• transferred to an acute care facility (DISP = 2)
• with missing discharge disposition (DISP=missing), gender (SEX=missing), age (AGE=missing), quarter (DQTR=missing), year (YEAR=missing), or principal diagnosis (DX1=missing)
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Most Recent Endorsement ActivityMeasure Retired and Endorsement Removed Surgery Project 2015-2017Initial EndorsementLast UpdatedRemoval Date
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Steward Organization EmailSteward Organization Copyright
The AHRQ QI software is publicly available. We have no copyright disclaimers.
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Risk Adjustment
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6.1.2 Current or Planned Use(s)
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Use In Federal Program
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