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2005 National Healthcare Quality Report

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Postoperative physiologic and metabolic derangements

Measure Source

Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators (PSI).


2.14 Postoperative physiologic and metabolic derangements per 1,000 elective surgical discharges (excluding some serious disease and obstetric admissions), United States, 2001 and 2002.

Data Source

AHRQ, Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project (HCUP), Nationwide Inpatient Sample.


All elective hospital surgical discharges, excluding some serious disease (i.e., patients with both a diagnosis code of ketoacidosis, hyperosmolarity, or other coma and a principal diagnosis of diabetes; patients with renal failure who were admitted for AMI, cardiac arrhythmia, cardiac arrest, shock, hemorrhage, or gastrointestinal hemorrhage; and obstetric admissions).


Subset of the denominator with any secondary diagnosis indicating physiologic and metabolic derangements.

Discharges with acute renal failure (subgroup of physiologic and metabolic derangements) must be accompanied by a procedure code for dialysis (3995, 5498).


Rates are adjusted by age, gender, age-gender interactions, comorbidities, and Diagnosis Related Groups (DRG) clusters. When reporting is by age, the adjustment is by gender, comorbidities, and DRG clusters; when reporting is by gender, the adjustment is by age, comorbidities, and DRG clusters.

Although not all States participate in the HCUP database, the Nationwide Inpatient Sample is weighted to give national estimates using weights based on all U.S. community, non-rehabilitation hospitals in the American Hospital Association Annual Survey of Hospitals.

This table was created using version 2.1, revision 2, of the AHRQ PSI software. This measure is referred to as indicator 10 in the software documentation. Further information about this and other safety and quality indicators is available from the AHRQ Quality Indicators website at

Postoperative respiratory failure. Postoperative hemorrhage or hematoma.


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