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2005 National Healthcare Quality Report

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Adverse events associated with hip joint replacement due to fracture

Measure Source

Centers for Medicare & Medicaid Services (CMS), Medicare Patient Safety Monitoring System (MPSMS).

Table

2.35 Percent of patients who had a hip joint replacement due to fracture with adverse events associated with the hip joint replacement, United States, 2002 and 2003.

Data Source

  1. CMS, MPSMS, inpatient medical records: for abstracted data related to the index hospital stay.
  2. CMS Medicare Administrative Data: used for 30-day post-procedure mortality, to identify procedure codes for hip arthroplasty and replacement and to determine 30-day post-procedure readmission.

Denominator

All patients in the MPSMS sample that experienced a surgical procedure performed to replace a fractured hip joint.

Numerator

Subset of the denominator who experienced at least 1 of the following:

Postoperative infections, postoperative pneumonia, postoperative urinary tract infection, postoperative deep vein thrombosis or pulmonary embolus, dislocation, wound complications other than infection, nerve injury, postoperative bleeding requiring 4 or more blood transfusions, cardiovascular complications, same side revision during the index hospital stay, return to or for reasons other than same side revision during the index hospital stay, and death.

Comments

Postoperative infections are determined by documentation of early prosthetic joint and/or wound infection and acute and early deep hip infection excluding superficial infection.

Postoperative pneumonia, postoperative urinary tract infection, postoperative deep vein thrombosis, and pulmonary embolus are all determined in the same fashion as those in prior MPSMS measures.

Cardiovascular complications include myocardial infarction, congestive heart failure, and arrhythmia requiring treatment.

Wound complications other than infection include dehiscence, hematoma, and necrosis.

In order to attain greater consistency between 2002 and 2003 data, the analytic approach used to produce these tables differs from earlier years of the NHQR.

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Adverse events associated with hip joint replacement due to fracture or degenerative conditions. Adverse events associated with hip joint replacement due to degenerative conditions.

 

 

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