Complications

Seven categories of surgical or postsurgical complications were identified in the data by means of their International Classification of Diseases, 10th Revision, Clinical Modification (ICD10-CM) codes. The seven categories do not capture all possible complications. These seven categories were considered for inclusion as they are potentially preventable complications that may be addressable with surgical quality improvement programs [20]. They include: surgical site infection; sepsis or septic shock; pulmonary embolism or deep vein thrombosis; myocardial infarction; cardiac arrest; pneumonia; and stroke. To be considered a complication, a diagnosis corresponding to any of the seven complication categories must not have been POA as confirmed by the POA indicator for each diagnosis. Patients who had such a diagnosis POA were excluded from the study. This was the case even if the patient developed one or more complications during the surgical or postsurgical period. The costs of readmissions were outside the scope of this study.