Association between Surgical Care Improvement Program venous thromboembolism measures and postoperative events

被引:34
作者
Altom, Laura K. [1 ,2 ,3 ]
Deierhoi, Rhiannon J. [1 ]
Grams, Jayleen [2 ]
Richman, Joshua S. [1 ,2 ]
Vick, Catherine C. [1 ]
Henderson, William G. [4 ,5 ]
Itani, Kamal M. F. [6 ,7 ]
Hawn, Mary T. [1 ,2 ]
机构
[1] Birmingham Vet Adm Hosp, Ctr Surg Med Acute Care Res & Transit, Birmingham, AL 35294 USA
[2] Univ Alabama Birmingham, Dept Surg, Sect Gastrointestinal Surg, Birmingham, AL 35294 USA
[3] Univ Alabama Birmingham, Hlth Serv Comparat Effectiveness Res Training Pro, Birmingham, AL USA
[4] Univ Colorado, Hlth Outcomes Program, Aurora, CO USA
[5] Colorado Sch Publ Hlth, Dept Biostat & Informat, Aurora, CO USA
[6] Boston Univ, Dept Surg, VA Boston Hlth Care Syst, Boston, MA 02215 USA
[7] Harvard Univ, Sch Med, Boston, MA USA
关键词
Surgical Care Improvement Program; SCIP measures; Postoperative outcomes; Venous thromboembolism; VTE; Deep venous thrombosis; DVT; Pulmonary embolism; PE; SCIP measure; Adherence; VTE risk factors; DEEP-VEIN THROMBOSIS; PROJECT MEASURES; INFECTION; PROPHYLAXIS; PREVENTION; RISK; ADHERENCE; OUTCOMES; SURGERY;
D O I
10.1016/j.amjsurg.2012.07.006
中图分类号
R61 [外科手术学];
学科分类号
摘要
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. Published by Elsevier Inc.
引用
收藏
页码:591 / 597
页数:7
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