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Are surgical patients at risk of venous thromboembolism currently meeting the Surgical Care Improvement Project performance measure for appropriate and timely prophylaxis?

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Abstract

The US Surgical Care Improvement Project (SCIP) has approved two performance measures to improve venous thromboembolism (VTE) prevention. SCIP-VTE-2 measures the proportion of surgery patients who received appropriate VTE prophylaxis within 24 h prior to surgery to 24 h after surgery. This study assesses the current rate of achievement of SCIP-VTE-2 criteria using a retrospective data set of real-world surgical patients. The Premier Perspective™ database, which contains real-world data from >400 US hospitals, was queried (January 2004–December 2006) for in-patient hospital transactional billing records of surgical patients aged ≥18 years. The primary outcome was the proportion of patients achieving SCIP-VTE-2 requirements for appropriate and timely prophylaxis as per the SCIP-VTE-2 algorithm. Of the 149,785 patients included, 56.2% received appropriate prophylaxis and 52.7% achieved the SCIP-VTE-2 performance measure for both appropriate and timely prophylaxis. To conclude, this study highlights that VTE prophylaxis currently only meets SCIP-VTE-2 requirements in approximately half of real-world surgical patients. The use of retrospective analyses such as this hospital billing data analysis may assist hospitals in measuring their current and future performance in VTE prevention.

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References

  1. Geerts WH, Bergqvist D, Pineo GF et al (2008) Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 133(6 Suppl):381–453

    Article  Google Scholar 

  2. Anderson FA Jr, Zayaruzny M, Heit JA et al (2007) Estimated annual numbers of US acute-care hospital patients at risk for venous thromboembolism. Am J Hematol 82:777–782

    Article  PubMed  Google Scholar 

  3. Amin AN, Stemkowski S, Lin J, Yang G (2008) Preventing venous thromboembolism in US hospitals: are surgical patients receiving appropriate prophylaxis? Thromb Haemost 99:796–797

    CAS  PubMed  Google Scholar 

  4. Friedman RJ, Gallus AS, Cushner FD et al (2008) Physician compliance with guidelines for deep-vein thrombosis prevention in total hip and knee arthroplasty. Curr Med Res Opin 24:87–97

    PubMed  Google Scholar 

  5. Joint Commission Performance Measurement Initiatives National Consensus Standards for Prevention and Care of Venous Thromboembolism (VTE). Available at: http://www.jointcommission.org/PerformanceMeasurement/PerformanceMeasurement/VTE.htm. Accessed 2 June 2008

  6. Leapfrog Hospital Survey. Available at: http://leapfrog.medstat.com/pdf/final.pdf. Accessed 18 June 2008

  7. Surgical Care Improvement Project (SCIP). Available at: http://www.medqic.org/dcs/ContentServer?cid=1137448680860&pagename=Medqic%2FMeasure%2FMeasuresHome&parentName=Topic&level3=Measures&c=MQParents. Accessed 9 June 2008

  8. Specifications Manual SCIP-VTE-2 Measure Information Form (MIF)/Flowchart (Algorithm). Available at: http://www.qualitynet.org/dcs/ContentServer?cid=1176726358615&pagename=QnetPublic%2FPage%2FQnetTier3&c=Page. Accessed 18 June 2008

  9. Geerts WH, Pineo GF, Heit JA et al (2004) Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 126(3 Suppl):338S–400S

    Article  CAS  PubMed  Google Scholar 

  10. Cohen AT, Tapson VF, Bergmann JF et al (2008) Venous thromboembolism risk and prophylaxis in the acute hospital care setting (ENDORSE study): a multinational cross-sectional study. Lancet 371:387–394

    Article  PubMed  Google Scholar 

  11. Spyropoulos AC, Lin J (2007) Direct medical costs of venous thromboembolism and subsequent hospital readmission rates: an administrative claims analysis from 30 managed care organizations. J Manag Care Pharm 13:475–486

    PubMed  Google Scholar 

  12. MacDougall DA, Feliu AL, Boccuzzi SJ et al (2006) Economic burden of deep vein thrombosis, pulmonary embolism and post-thrombotic syndrome. Am J Health Syst Pharm 63(20 Suppl 6):S5–S15

    Article  PubMed  Google Scholar 

  13. Botteman MF, Caprini J, Stephens JM et al (2002) Results of an economic model to assess the cost-effectiveness of enoxaparin, a low-molecular-weight heparin, versus warfarin for the prophylaxis of deep vein thrombosis and associated long-term complications in total hip replacement surgery in the United States. Clin Ther 24:1960–1986

    Article  CAS  PubMed  Google Scholar 

  14. Heerey A, Suri S (2005) Cost effectiveness of dalteparin for preventing venous thromboembolism in abdominal surgery. Pharmacoeconomics 23:927–944

    Article  PubMed  Google Scholar 

  15. CMS Hospital Compare website. Available at: http://www.cms.hhs.gov/HospitalQualityInits/25_HospitalCompare.asp. Accessed 18 June 2008

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Acknowledgement

Financial and editorial support for this publication was provided by sanofi-aventis US, Inc.

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Authors and Affiliations

  1. Ochsner Hospital, Ochsner Clinic Foundation, 1514 Jefferson Hwy, New Orleans, LA, 70121-2429, USA

    Steven B. Deitelzweig

  2. sanofi-aventis, Bridgewater, NJ, USA

    Jay Lin

  3. IMS Health, Falls Church, VA, USA

    Mohamed Hussein & David Battleman

Authors
  1. Steven B. Deitelzweig
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  2. Jay Lin
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  3. Mohamed Hussein
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  4. David Battleman
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Corresponding author

Correspondence to Steven B. Deitelzweig.

Appendices

Appendix 1: ICD-9 codes for exclusion criteria

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Appendix 2: SCIP VTE-2 algorithm

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Deitelzweig, S.B., Lin, J., Hussein, M. et al. Are surgical patients at risk of venous thromboembolism currently meeting the Surgical Care Improvement Project performance measure for appropriate and timely prophylaxis?. J Thromb Thrombolysis 30, 55–66 (2010). https://doi.org/10.1007/s11239-009-0393-4

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  • DOI: https://doi.org/10.1007/s11239-009-0393-4

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