Association between Surgical Care Improvement Program venous thromboembolism measures and postoperative events - 08/11/12

Doi : 10.1016/j.amjsurg.2012.07.006

Laura K. Altom, M.D., M.S.P.H. ^a,^b,^c, Rhiannon J. Deierhoi, M.P.H. ^a, Jayleen Grams, M.D. ^b, Joshua S. Richman, M.D., Ph.D. ^a,^b, Catherine C. Vick, M.S. ^a, William G. Henderson, Ph.D. ^d, Kamal M.F. Itani, M.D. ^e, Mary T. Hawn, M.D., M.P.H. ^a,^b,^⁎
^a The Center for Surgical, Medical Acute Care Research and Transitions, Birmingham Veterans Administration Hospital, 1530 3rd Ave. South, KB 428, Birmingham, AL 35294, USA
^b Section of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
^c Health Services/Comparative Effectiveness Research Training Program, University of Alabama at Birmingham, Birmingham, AL, USA
^d University of Colorado Health Outcomes Program and Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO, USA
^e Department of Surgery, VA Boston Health Care System, Boston University and Harvard Medical School, Boston, MA, USA

Corresponding author: Tel.: +1-205-975-1932; fax: +1-205-996-4959

Abstract

Background

In 2006, the Surgical Care Improvement Program (SCIP) implemented measures to reduce venous thromboembolism (VTE). There are little data on whether these measures reduce VTE rates. This study proposed to examine associations between SCIP-VTE adherence and VTE rates.

Methods

SCIP-VTE adherence for 30,531 surgeries from 2006 to 2009 was linked with VA Surgical Quality Improvement Program data. Patient demographics, comorbidities, and surgical characteristics associated with VTE were summarized. VTE rates were compared by SCIP-VTE adherence. Multivariable logistic regression was used to model VTE by adherence, adjusting for multiple associated factors.

Results

Of 30,531 surgeries, 89.9% adhered to SCIP-VTE; 1.4% experienced VTE. Logistic regression identified obesity, smoking, functional status, weight loss, emergent status, age older than 64 years, and surgical time as associated with VTE. SCIP-VTE was not associated with VTE (1.4% vs 1.33%; P = .3), even after adjustment.

Conclusions

This study identified several important risk factors for VTE but found no association with SCIP-VTE adherence.

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Keywords : Surgical Care Improvement Program, SCIP measures, Postoperative outcomes, Venous thromboembolism, VTE, Deep venous thrombosis, DVT, Pulmonary embolism, PE, SCIP measure, Adherence, VTE risk factors

Plan

Population characteristics

Univariate analyses

Multivariable regression analyses

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Conclusions

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Vol 204 - N° 5

P. 591-597 - novembre 2012 Retour au numéro

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Association between Surgical Care Improvement Program venous thromboembolism measures and postoperative events - 08/11/12

Abstract

Background

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Conclusions

Plan

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