Table 1Selected PSIs and denominator definitions

Adopted from AHRQ Technical Specifications, Version 3.0a, May 1, 2006. See AHRQ manual for further exclusions.)

PSI titleSelected PSI for ICD-10-WHO translationDenominator populationMajor diagnosis category (MDC) exclusionProcedure codes requirement
PSI 1: Complications of anesthesiaYesAll surgical discharges age ≥18 years or MDC 14 (pregnancy, childbirth, and puerperium)NoNo
PSI 2: Death in low-mortalityNo, because it heavily relies on DRG
PSI 3: Decubitus ulcerYesAll medical and surgical discharges age ≥18 years, length of stay >4 daysMDC 9 (skin, subcutaneous tissue, and breast); MDC 14 (pregnancy, childbirth, and puerperium)Yes, debridement or pedicle graft
PSI 4: Failure to rescueNo, because many procedure codes are required
PSI 5: Foreign body left during procedureYesAll surgical and medical discharges age ≥18 years or MDC 14 (pregnancy, childbirth, and puerperium)NoNo
PSI 6: Iatrogenic pneumothoraxYesAll surgical and medical discharges age ≥18 yearsYes, diaphragmatic surgery repair, thoracic surgery, lung or pleural biopsy, or cardiac surgery
PSI 7: Selected infections due to medical careYesAll surgical and medical discharges age ≥18 yearsNoNo
PSI 8: Postoperative hip fractureYesAll surgical discharges age ≥18 yearsMDC 8 (diseases and disorders of the musculoskeletal system and connective tissue); MDC14 (pregnancy, childbirth, and puerperium)Yes, hip fracture repair
PSI 9: Postoperative hemorrhage or hematomaNo, because many procedure codes are required
PSI 10: Postoperative physiologic and metabolic derangementYesAll surgical discharges age ≥18MDC 14 (pregnancy, childbirth, and puerperium)Yes, dialysis
PSI 11: Postoperative respiratory failureNo, because many procedure codes are required
PSI 12: Postoperative pulmonary embolism or deep vein thrombosisYesAll surgical discharges age ≥18MDC 14 (pregnancy, childbirth, and puerperium)Yes, interruption of vena cava
PSI 13: Postoperative sepsisYesAll elective (defined by the admission type) surgical discharges age ≥18 years and length of stay >3 daysMDC 14 (pregnancy, childbirth, and puerperium)No
PSI 14: Postoperative wound dehiscence RequiredNo, because many procedure codes are
PSI 15: Accidental puncture or laceration = Technical difficulty with procedureYesAll surgical and medical discharges age ≥18 yearsMDC 14 (pregnancy, childbirth, and puerperium)No
PSI 16: Transfusion reactionYesAll surgical and medical discharges age ≥18 years or MDC 14 (pregnancy, childbirth, and puerperium)NoNo
PSI 17: Birth trauma – injury to neonateYesAll liveborn births (newborns)NoNo
PSI 18: Obstetric trauma– vaginal delivery with instrumentYes (PSI 18 and 19 are joined to form one PSI)All vaginal delivery discharge PatientsNoYes, obstetric trauma repair
PSI 19: Obstetric trauma– vaginal delivery without instrument
PSI 20: Obstetric trauma– cesarean deliveryYesAll cesarean delivery dischargesNoYes, obstetric trauma repair; cesarean section

From: Adaptation of AHRQ Patient Safety Indicators for Use in ICD-10 Administrative Data by an International Consortium

Cover of Advances in Patient Safety: New Directions and Alternative Approaches (Vol. 1: Assessment)
Advances in Patient Safety: New Directions and Alternative Approaches (Vol. 1: Assessment).
Henriksen K, Battles JB, Keyes MA, et al., editors.

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