Table 1

Specifications for identification of serious treatable complications after hip fracture surgery

Complication*Definition†
Shock/MINumerator: secondary diagnosis code for shock/MI‡
Denominator: surgical discharge, for patients aged ≥65 years with ICD-9-CM code for hip fracture surgery; and surgery within 4 days of admission or urgent admission type
Exclude cases: principal diagnosis for shock, MI, haemorrhage, or GI haemorrhage; any listed procedure code for lung cancer resection; major diagnostic category 4 (diseases/disorder of respiratory system) or 5 (diseases/disorders of circulatory system); discharge disposition of transfer to acute care; or missing discharge disposition, age, or sex
SepsisNumerator: secondary diagnosis code for sepsis‡
Denominator: surgical discharge, for patients aged ≥65 years with ICD-9-CM code for hip fracture surgery; and surgery within 4 days of admission or emergency admission type
Exclude cases: principal diagnosis for sepsis or infection; any listed diagnosis or procedure code for immunocompromised state; length of stay <4 days; or discharge disposition of transfer to acute care; or missing discharge disposition, age or sex
PneumoniaNumerator: secondary diagnosis code for pneumonia‡
Denominator: surgical discharge, for patients aged≥65 years with ICD-9-CM code for hip fracture surgery; and surgery within 4 days of admission or emergency admission type
Exclude cases: principal diagnosis for pneumonia or respiratory complications; any listed diagnosis code for viral pneumonia, influenza or immunocompromised state; any listed procedure code for lung cancer; major diagnostic category 4 (diseases/disorder of respiratory system) or discharge disposition of transfer to acute care; or missing discharge disposition, age or sex
DVT/PENumerator: secondary diagnosis code for DVT/PE‡
Denominator: surgical discharge, for patients aged ≥65 years with ICD-9-CM code for hip fracture surgery; and surgery within 4 days of admission or emergency admission type
Exclude cases: principal diagnosis for DVT/PE; discharge disposition of transfer to acute care; missing discharge disposition, age or sex
GI haemorrhage/ acute ulcerNumerator: secondary diagnosis code for GI haemorrhage/acute ulcer‡
Denominator: surgical discharge, for patients aged ≥65 years with ICD-9-CM code for hip fracture surgery; and surgery within 4 days of admission or emergency admission type
Exclude cases: principal diagnosis for GI haemorrhage, acute ulcer, alcoholism, or anaemia; major diagnostic category 6 (diseases/disorder of digestive system) or 7 (diseases/disorders of hepatobiliary system and pancreas); discharge disposition of transfer to acute care; or missing discharge disposition, age, or sex
  • * Identified from complications listed in AHRQ QI Research Version 5.0, Patient Safety Indicators 04, Technical Specifications.

  • Modified from AHRQ QI Research Version 5.0, Patient Safety Indicators 04, Technical Specifications.

  • Identified from secondary ICD-9-CM diagnosis codes listed in AHRQ QI Research Version 5.0, Patient Safety Indicators 04, Technical Specifications, Death Rate among Surgical Inpatients with Serious Treatable Complications.

  • DVT, deep venous thrombosis; GI, gastrointestinal; MI, myocardial infarction; PE, pulmonary embolism.