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.
Number of deaths (DISP=20) among cases meeting the inclusion and exclusion rules for the denominator.
Denominator
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.”
Exclusions
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)
Measure Record
Most Recent Endorsement Activity
Measure Retired and Endorsement Removed Surgery Project 2015-2017
Initial Endorsement
Last Updated
Removal Date
Point of Contact
Steward Organization
Agency for Healthcare Research and Quality
Steward POC email
Pam.Owens@ahrq.hhs.gov
Steward Organization Copyright
The AHRQ QI software is publicly available. We have no copyright disclaimers.
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