No Association Between Hospital-Reported Perioperative Venous Thromboembolism Prophylaxis and Outcome Rates in Publicly Reported Data | Health Care Safety | JAMA Surgery | JAMA Network
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Research Letter
April 2014

No Association Between Hospital-Reported Perioperative Venous Thromboembolism Prophylaxis and Outcome Rates in Publicly Reported Data

Author Affiliations
  • 1Division of Acute Care Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 2Center for Surgical Trials and Outcomes Research, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 3Division of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 4Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 5Armstrong Institute for Patient Quality and Safety, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 6Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 7Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
JAMA Surg. 2014;149(4):400-401. doi:10.1001/jamasurg.2013.4935

Venous thromboembolism (VTE), consisting of deep vein thrombosis (DVT) and pulmonary embolism, is an important cause of postoperative mortality and long-term morbidity. Because many events are preventable, VTE prophylaxis performance and postoperative VTE are used as measures of hospital quality of care and patient safety. Two such metrics are reported on the Centers for Medicare & Medicaid Services Hospital Compare website (http://www.medicare.gov/hospitalcompare/search.html) with the stated goal of helping consumers make decisions about where to receive their health care.

The Surgical Care Improvement Project (SCIP) VTE-2, a process measure, captures the percentage of a hospital’s surgical patients who received any VTE prophylaxis within 24 hours of surgery. Previous studies have shown that performance on the SCIP VTE-2 measure is not associated with VTE among Medicare patients in 6 high-risk surgical procedures,1 nor with outcomes in a Veterans Affairs cohort.2 In October 2011, Hospital Compare made additional VTE outcomes data available to consumers. We hypothesized that there is no association between the process measure (SCIP VTE-2) and the outcome (Agency for Healthcare Research and Quality Patient Safety Indicator [PSI]–12, a risk-adjusted postoperative VTE rate based on administrative data).

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