Table 1Definitions of accepted hospital-level AHRQ Patient Safety Indicators (excludes obstetric and birth trauma indicators)

IndicatorNumeratorDenominator
Complications of anesthesiaDischarge with codes for anesthesia complications in any secondary diagnosis fieldAll surgical discharges. Exclude patients with codes for poisoning due to anesthetics and any diagnosis code for active drug dependence, active nondependent abuse of drugs, or self-inflicted injury.
Death in low mortality DRGsDischarges with disposition of “deceased”Patients in DRGs with less than 0.5% mortality rate, based on NIS 1997 data. Exclude patients with any code for trauma, immuocompromised state, or cancer.
Decubitus ulcerDischarges with decubitus ulcer in any secondary diagnosis fieldAll medical and surgical discharges. Include only patients with LOS > 4 days. Exclude patients in MDC 9 or patients with any diagnosis of hemiplagia, paraplegia, quadriplegia. Exclude patients admitted from a long-term care facility.
Failure to rescueAll discharges with disposition of “deceased”Discharges with potential complications of care used in failure to rescue definition (i.e., pneumonia, DVT/PE, sepsis, acute renal failure, shock/cardiac arrest, or GI hemorrhage/acute ulcer). Exclusion criteria specific to each diagnosis. Also exclude patients transferred to or from acute care facility; age 75 and older; or admitted from long-term care facility.
Foreign body left in during procedureDischarges with codes for foreign body left in during procedure in any secondary diagnosis fieldAll medical and surgical discharges.
Iatrogenic pneumothoraxDischarges with ICD-9-CM codes of 512.1 in any secondary diagnosis fieldAll surgical and medical discharges. Exclude patients with any diagnosis of trauma or any code indicating thoracic surgery or lung or pleural biopsy or cardiac surgery.
Infection due to medical careDischarges with ICD-9-CM code of 999.3 or 996.62 in any secondary diagnosis fieldAll surgical and medical discharges. Exclude patients with any code for immunocompromised state or cancer.
In-hospital hip fractureDischarges with code for hip fracture in any secondary diagnosis fieldAll surgical discharges. Excludes patients who have musculoskeletal and connective tissue disease (MDC 8); or with principal diagnosis codes for seizure, syncope, stroke, coma, cardiac arrest, poisoning, trauma, delirium and other psychoses, or anoxic brain injury; or with any diagnosis of metastatic cancer, lymphoid malignancy, bone malignancy or self-inflicted injury.
Postoperative hemorrhage or hematomaDischarges with codes for postoperative hemorrhage or hematoma in any secondary diagnosis field AND code for postoperative control of hemorrhage or hematoma in any secondary procedure code field. Code for postoperative control of hemorrhage or hematoma must occur on the same day or after the principal procedure.All surgical discharges.
Postoperative physiologic and metabolic derangementDischarges with codes for physiologic and metabolic derangements in any secondary diagnosis fieldAll elective surgical discharges. Exclude patients with both a diagnosis code of ketoacidosis, hyperosmolarity or other coma (subgroups of physiologic and metabolic derangements coding) AND a principal diagnosis of diabetes; exclude patients with both a secondary diagnosis code for acute renal failure (subgroup of physiologic and metabolic derangements coding) AND a principal diagnosis of acute myocardial infarction, cardiac arrhythmia, cardiac arrest, shock, hemorrhage or gastrointestinal hemorrhage.
Postoperative respiratory failureDischarges with ICD-9-CM codes for acute respiratory failure (518.81) in any secondary diagnosis fieldAll elective surgical discharges. Exclude patients with respiratory or circulatory diseases (MDC 4 and MDC 5).
Postoperative pulmonary embolism or deep vein thrombosisDischarges with codes for deep vein thrombosis or pulmonary embolism in any secondary diagnosis fieldAll surgical discharges. Exclude patients with a principal diagnosis of deep vein thrombosis, patients with secondary procedure code 38.7 when this procedure occurs on the day of or before the day of principal procedure.
Postoperative sepsisDischarges with code for septicemia in any secondary diagnosis fieldAll elective surgical discharges. Exclude patients with a principal diagnosis of infection, or any code for immuncompromised state, or cancer. Include only patients with a length of stay of more than 3 days.
Accidental puncture or lacerationDischarges with code denoting technical difficulty (e.g., accidental cut, puncture, perforation or laceration during a procedure) in any secondary diagnosis fieldAll medical and surgical discharges.
Transfusion reactionDischarges with codes for transfusion reaction in any secondary diagnosis field per 100 discharges.All medical and surgical discharges.
Postoperative wound dehiscenceDischarges with ICD-9-CM codes for reclosure of postoperative disruption of abdominal wall (54.61) in any secondary procedure fieldAll abdominopelvic surgical discharges.

From: Applying Patient Safety Indicators (PSIs) Across Health Care Systems: Achieving Data Comparability

Cover of Advances in Patient Safety: From Research to Implementation (Volume 2: Concepts and Methodology)
Advances in Patient Safety: From Research to Implementation (Volume 2: Concepts and Methodology).
Henriksen K, Battles JB, Marks ES, et al., editors.

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