Readmissions for venous thromboembolism: expanding the definition of patient safety indicators.
BACKGROUND
The Agency for Healthcare Research and Quality (AHRQ) defines its venous thromboembolism (VTE) patient safety indicator (PSI) as surgical cases with a secondary diagnosis of pulmonary embolism or deep vein thrombosis. Short-term readmissions for VTE are excluded because most state administrative databases are unable to track readmissions.


METHODS
Patients meeting the AHRQ VTE PSI definition and those readmitted with a VTE principal diagnosis within 30 days of a prior surgical hospitalization were identified on the basis of inpatient discharge data.


RESULTS
A total of 4,906 surgical discharges in New York met the AHRQ VTE PSI definition in 2001. An additional 1,059 cases of VTE were found when surgical patients with a short-term readmission for VTE were identified. Patients readmitted with VTE were less likely to die but were more likely to have a pulmonary embolism and were more likely to be white and non-Hispanic compared to those who met the AHRQ VTE PSI definition.


CONCLUSIONS
Short-term readmissions for VTE represent potentially important cases to capture when monitoring adverse events. Prophylaxis, monitoring, and patient education may be required after hospital discharge to prevent or treat VTE as early as possible. Data systems that can track patients across multiple admissions to identify complications resulting in short-term readmissions are needed.
Department of Health Policy, Management, and Behavior, University at Albany School of Public Health, Rensselaer, New York, USA. wweller@albany.edu
Wendy E
WE
Weller
Brian K
BK
Gallagher
Liyi
L
Cen
Edward L
EL
Hannan
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D011785:Quality Assurance, Health Care; D019984:Quality Indicators, Health Care; D017751:Safety Management / Q000592:standards*; D013923:Thromboembolism / Q000150:complications / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control