- Initial Population =
- AND: Age>= 18 year(s) at: Occurrence A of $EncounterInpatient
- AND NOT: Union of:
- Intersection of:
- Occurrence A of $EncounterInpatient
- "Encounter, Performed: Encounter Inpatient" satisfies any:
- (diagnosis: Obstetrics)
- (diagnosis: Venous Thromboembolism)
- (diagnosis: Obstetrics VTE)
- Union of:
- "Diagnosis: Obstetrics"
- $DiagnosisVTE
- starts during Occurrence A of $EncounterInpatient
- Union of:
- "Diagnosis: Obstetrics"
- $DiagnosisVTE
- starts during ("Encounter, Performed: Emergency Department Visit" <= 1 hour(s) ends before or concurrent with start of Occurrence A of $EncounterInpatient )
- Denominator =
- Denominator Exclusions =
- OR: Intersection of:
- Occurrence A of $EncounterInpatient
- "Encounter, Performed: Encounter Inpatient (length of stay < 2 day(s))"
- OR: "Encounter, Performed: ICU Admission or Transfer (length of stay >= 1 day(s))" <= 1 day(s) starts after or concurrent with start of Occurrence A of $EncounterInpatient
- OR: Intersection of:
- Occurrence A of $EncounterInpatient
- "Encounter, Performed: Encounter Inpatient" satisfies any:
- (principal diagnosis: Mental Health Diagnoses)
- (principal diagnosis: Hemorrhagic Stroke)
- (principal diagnosis: Ischemic Stroke)
- OR: Union of:
- "Procedure, Performed: General Surgery (ordinality: Principal)"
- "Procedure, Performed: Gynecological Surgery (ordinality: Principal)"
- "Procedure, Performed: Hip Fracture Surgery (ordinality: Principal)"
- "Procedure, Performed: Hip Replacement Surgery (ordinality: Principal)"
- "Procedure, Performed: Intracranial Neurosurgery (ordinality: Principal)"
- "Procedure, Performed: Knee Replacement Surgery (ordinality: Principal)"
- "Procedure, Performed: Urological Surgery (ordinality: Principal)"
- during Occurrence A of $EncounterInpatient
- OR: $InterventionComfortMeasures <= 1 day(s) starts after or concurrent with start of ("Encounter, Performed: Emergency Department Visit" <= 1 hour(s) ends before or concurrent with start of Occurrence A of $EncounterInpatient )
- OR: $InterventionComfortMeasures <= 1 day(s) starts after or concurrent with start of Occurrence A of $EncounterInpatient
- OR: $InterventionComfortMeasures <= 1 day(s) starts after or concurrent with end of ("Procedure, Performed: General or Neuraxial Anesthesia" <= 1 day(s) ends after or concurrent with start of Occurrence A of $EncounterInpatient )
- Numerator =
- AND:
- # VTE prophylaxis options
- OR: Union of:
- $MedicationVTEProphylaxis <= 1 day(s) starts after or concurrent with start of Occurrence A of $EncounterInpatient
- $MedicationVTEProphylaxis <= 1 day(s) starts after or concurrent with end of ("Procedure, Performed: General or Neuraxial Anesthesia" <= 1 day(s) ends after or concurrent with start of Occurrence A of $EncounterInpatient )
- $DeviceVTEProphylaxis <= 1 day(s) starts after or concurrent with start of Occurrence A of $EncounterInpatient
- $DeviceVTEProphylaxis <= 1 day(s) starts after or concurrent with end of ("Procedure, Performed: General or Neuraxial Anesthesia" <= 1 day(s) ends after or concurrent with start of Occurrence A of $EncounterInpatient )
- OR:
- AND: "Medication, Administered: Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment" satisfies any:
- <= 1 day(s) starts after or concurrent with start of Occurrence A of $EncounterInpatient
- <= 1 day(s) starts after or concurrent with end of ("Procedure, Performed: General or Neuraxial Anesthesia" <= 1 day(s) ends after or concurrent with start of Occurrence A of $EncounterInpatient )
- AND:
- OR: Union of:
- Intersection of:
- Occurrence A of $EncounterInpatient
- "Encounter, Performed: Encounter Inpatient (diagnosis: Atrial Fibrillation/Flutter)"
- "Diagnosis: Atrial Fibrillation/Flutter" starts before or concurrent with end of Occurrence A of $EncounterInpatient
- "Diagnosis: Venous Thromboembolism" starts before start of Occurrence A of $EncounterInpatient
- OR: Union of:
- "Procedure, Performed: Hip Replacement Surgery"
- "Procedure, Performed: Knee Replacement Surgery"
- starts before or concurrent with end of Occurrence A of $EncounterInpatient
- # Reasons for no VTE prophylaxis
- OR: Union of:
- "Assessment, Performed: VTE Risk Assessment (result: Low Risk)"
- "Laboratory Test, Performed: INR (result > 3.0 )"
- "Medication, Administered: Unfractionated Heparin (route: Intravenous route)"
- "Medication, Administered: Direct Thrombin Inhibitor"
- "Medication, Administered: Glycoprotein IIb/IIIa Inhibitors"
- starts during ("Encounter, Performed: Emergency Department Visit" <= 1 hour(s) ends before or concurrent with start of Occurrence A of $EncounterInpatient )
- OR: Union of:
- "Assessment, Performed: VTE Risk Assessment (result: Low Risk)"
- "Laboratory Test, Performed: INR (result > 3.0 )"
- "Medication, Administered: Unfractionated Heparin (route: Intravenous route)"
- "Medication, Administered: Direct Thrombin Inhibitor"
- "Medication, Administered: Glycoprotein IIb/IIIa Inhibitors"
- <= 1 day(s) starts after or concurrent with start of Occurrence A of $EncounterInpatient
- OR: Union of:
- "Assessment, Performed: VTE Risk Assessment (result: Low Risk)"
- "Laboratory Test, Performed: INR (result > 3.0 )"
- "Medication, Administered: Unfractionated Heparin (route: Intravenous route)"
- "Medication, Administered: Direct Thrombin Inhibitor"
- "Medication, Administered: Glycoprotein IIb/IIIa Inhibitors"
- <= 1 day(s) starts after or concurrent with end of ("Procedure, Performed: General or Neuraxial Anesthesia" <= 1 day(s) ends after or concurrent with start of Occurrence A of $EncounterInpatient )
- OR:
- AND: $NoMedicationVTEProphylaxisMedicalReason starts during ("Encounter, Performed: Emergency Department Visit" <= 1 hour(s) ends before or concurrent with start of Occurrence A of $EncounterInpatient )
- AND: $NoDeviceVTEProphylaxisMedicalReason starts during ("Encounter, Performed: Emergency Department Visit" <= 1 hour(s) ends before or concurrent with start of Occurrence A of $EncounterInpatient )
- OR:
- AND: $NoMedicationVTEProphylaxisMedicalReason <= 1 day(s) starts after or concurrent with start of Occurrence A of $EncounterInpatient
- AND: $NoDeviceVTEProphylaxisMedicalReason <= 1 day(s) starts after or concurrent with start of Occurrence A of $EncounterInpatient
- OR:
- AND: $NoMedicationVTEProphylaxisMedicalReason <= 1 day(s) starts after or concurrent with end of ("Procedure, Performed: General or Neuraxial Anesthesia" <= 1 day(s) ends after or concurrent with start of Occurrence A of $EncounterInpatient )
- AND: $NoDeviceVTEProphylaxisMedicalReason <= 1 day(s) starts after or concurrent with end of ("Procedure, Performed: General or Neuraxial Anesthesia" <= 1 day(s) ends after or concurrent with start of Occurrence A of $EncounterInpatient )
- OR: Union of:
- $NoVTEProphylaxisPatientRefusal <= 1 day(s) starts after or concurrent with start of Occurrence A of $EncounterInpatient
- $NoVTEProphylaxisPatientRefusal <= 1 day(s) starts after or concurrent with end of ("Procedure, Performed: General or Neuraxial Anesthesia" <= 1 day(s) ends after or concurrent with start of Occurrence A of $EncounterInpatient )
- $NoVTEProphylaxisPatientRefusal starts during ("Encounter, Performed: Emergency Department Visit" <= 1 hour(s) ends before or concurrent with start of Occurrence A of $EncounterInpatient )
- Numerator Exclusions =
- Denominator Exceptions =
- Stratification =
- $DeviceVTEProphylaxis =
- Union of:
- "Device, Applied: Intermittent pneumatic compression devices (IPC)"
- "Device, Applied: Venous foot pumps (VFP)"
- "Device, Applied: Graduated compression stockings (GCS)"
- $DiagnosisVTE =
- Union of:
- "Diagnosis: Venous Thromboembolism"
- "Diagnosis: Obstetrics VTE"
- $EncounterInpatient =
- "Encounter, Performed: Encounter Inpatient" satisfies all:
- (length of stay <= 120 day(s))
- ends during "Measurement Period"
- $InterventionComfortMeasures =
- Union of:
- "Intervention, Order: Comfort Measures"
- "Intervention, Performed: Comfort Measures"
- $MedicationVTEProphylaxis =
- Union of:
- "Medication, Administered: Low Dose Unfractionated Heparin for VTE Prophylaxis (route: Subcutaneous route)"
- "Medication, Administered: Low Molecular Weight Heparin for VTE Prophylaxis"
- "Medication, Administered: Injectable Factor Xa Inhibitor for VTE Prophylaxis"
- "Medication, Administered: Warfarin"
- $NoDeviceVTEProphylaxisMedicalReason =
- Union of:
- "Device, Applied not done: Medical Reason" for "Intermittent pneumatic compression devices (IPC)"
- "Device, Applied not done: Medical Reason" for "Venous foot pumps (VFP)"
- "Device, Applied not done: Medical Reason" for "Graduated compression stockings (GCS)"
- "Device, Order not done: Medical Reason" for "Intermittent pneumatic compression devices (IPC)"
- "Device, Order not done: Medical Reason" for "Venous foot pumps (VFP)"
- "Device, Order not done: Medical Reason" for "Graduated compression stockings (GCS)"
- $NoMedicationVTEProphylaxisMedicalReason =
- Union of:
- "Medication, Administered not done: Medical Reason" for "Low Dose Unfractionated Heparin for VTE Prophylaxis"
- "Medication, Administered not done: Medical Reason" for "Low Molecular Weight Heparin for VTE Prophylaxis"
- "Medication, Administered not done: Medical Reason" for "Injectable Factor Xa Inhibitor for VTE Prophylaxis"
- "Medication, Administered not done: Medical Reason" for "Warfarin"
- "Medication, Order not done: Medical Reason" for "Low Dose Unfractionated Heparin for VTE Prophylaxis"
- "Medication, Order not done: Medical Reason" for "Low Molecular Weight Heparin for VTE Prophylaxis"
- "Medication, Order not done: Medical Reason" for "Injectable Factor Xa Inhibitor for VTE Prophylaxis"
- "Medication, Order not done: Medical Reason" for "Warfarin"
- $NoVTEProphylaxisPatientRefusal =
- Union of:
- "Medication, Administered not done: Patient Refusal" for "Low Dose Unfractionated Heparin for VTE Prophylaxis"
- "Medication, Administered not done: Patient Refusal" for "Low Molecular Weight Heparin for VTE Prophylaxis"
- "Medication, Administered not done: Patient Refusal" for "Injectable Factor Xa Inhibitor for VTE Prophylaxis"
- "Medication, Administered not done: Patient Refusal" for "Warfarin"
- "Medication, Order not done: Patient Refusal" for "Low Dose Unfractionated Heparin for VTE Prophylaxis"
- "Medication, Order not done: Patient Refusal" for "Low Molecular Weight Heparin for VTE Prophylaxis"
- "Medication, Order not done: Patient Refusal" for "Injectable Factor Xa Inhibitor for VTE Prophylaxis"
- "Medication, Order not done: Patient Refusal" for "Warfarin"
- "Device, Applied not done: Patient Refusal" for "Intermittent pneumatic compression devices (IPC)"
- "Device, Applied not done: Patient Refusal" for "Venous foot pumps (VFP)"
- "Device, Applied not done: Patient Refusal" for "Graduated compression stockings (GCS)"
- "Device, Order not done: Patient Refusal" for "Intermittent pneumatic compression devices (IPC)"
- "Device, Order not done: Patient Refusal" for "Venous foot pumps (VFP)"
- "Device, Order not done: Patient Refusal" for "Graduated compression stockings (GCS)"
- "Assessment, Performed: VTE Risk Assessment" using "VTE Risk Assessment LOINC Value Set (2.16.840.1.113883.3.117.1.7.1.357)"
- "Device, Applied: Graduated compression stockings (GCS)" using "Graduated compression stockings (GCS) SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.256)"
- "Device, Applied: Intermittent pneumatic compression devices (IPC)" using "Intermittent pneumatic compression devices (IPC) SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.214)"
- "Device, Applied: Venous foot pumps (VFP)" using "Venous foot pumps (VFP) SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.230)"
- "Device, Applied not done: Medical Reason" using "Medical Reason SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.473)"
- "Device, Applied not done: Patient Refusal" using "Patient Refusal SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.93)"
- "Device, Order: Graduated compression stockings (GCS)" using "Graduated compression stockings (GCS) SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.256)"
- "Device, Order: Intermittent pneumatic compression devices (IPC)" using "Intermittent pneumatic compression devices (IPC) SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.214)"
- "Device, Order: Venous foot pumps (VFP)" using "Venous foot pumps (VFP) SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.230)"
- "Device, Order not done: Medical Reason" using "Medical Reason SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.473)"
- "Device, Order not done: Patient Refusal" using "Patient Refusal SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.93)"
- "Diagnosis: Atrial Fibrillation/Flutter" using "Atrial Fibrillation/Flutter Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.202)"
- "Diagnosis: Obstetrics" using "Obstetrics Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.263)"
- "Diagnosis: Obstetrics VTE" using "Obstetrics VTE Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.264)"
- "Diagnosis: Venous Thromboembolism" using "Venous Thromboembolism Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.279)"
- "Encounter, Performed: Emergency Department Visit" using "Emergency Department Visit SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.292)"
- "Encounter, Performed: Encounter Inpatient" using "Encounter Inpatient SNOMEDCT Value Set (2.16.840.1.113883.3.666.5.307)"
- "Encounter, Performed: ICU Admission or Transfer" using "ICU Admission or Transfer SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.305)"
- "Intervention, Order: Comfort Measures" using "Comfort Measures SNOMEDCT Value Set (1.3.6.1.4.1.33895.1.3.0.45)"
- "Intervention, Performed: Comfort Measures" using "Comfort Measures SNOMEDCT Value Set (1.3.6.1.4.1.33895.1.3.0.45)"
- "Laboratory Test, Performed: INR" using "INR LOINC Value Set (2.16.840.1.113883.3.117.1.7.1.213)"
- "Medication, Administered: Direct Thrombin Inhibitor" using "Direct Thrombin Inhibitor RXNORM Value Set (2.16.840.1.113883.3.117.1.7.1.205)"
- "Medication, Administered: Glycoprotein IIb/IIIa Inhibitors" using "Glycoprotein IIb/IIIa Inhibitors RXNORM Value Set (2.16.840.1.113762.1.4.1045.41)"
- "Medication, Administered: Injectable Factor Xa Inhibitor for VTE Prophylaxis" using "Injectable Factor Xa Inhibitor for VTE Prophylaxis RXNORM Value Set (2.16.840.1.113883.3.117.1.7.1.211)"
- "Medication, Administered: Low Dose Unfractionated Heparin for VTE Prophylaxis" using "Low Dose Unfractionated Heparin for VTE Prophylaxis RXNORM Value Set (2.16.840.1.113762.1.4.1045.39)"
- "Medication, Administered: Low Molecular Weight Heparin for VTE Prophylaxis" using "Low Molecular Weight Heparin for VTE Prophylaxis RXNORM Value Set (2.16.840.1.113883.3.117.1.7.1.219)"
- "Medication, Administered: Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment" using "Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment RXNORM Value Set (2.16.840.1.113883.3.117.1.7.1.134)"
- "Medication, Administered: Unfractionated Heparin" using "Unfractionated Heparin RXNORM Value Set (2.16.840.1.113883.3.117.1.7.1.218)"
- "Medication, Administered: Warfarin" using "Warfarin RXNORM Value Set (2.16.840.1.113883.3.117.1.7.1.232)"
- "Medication, Administered not done: Medical Reason" using "Medical Reason SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.473)"
- "Medication, Administered not done: Patient Refusal" using "Patient Refusal SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.93)"
- "Medication, Order: Injectable Factor Xa Inhibitor for VTE Prophylaxis" using "Injectable Factor Xa Inhibitor for VTE Prophylaxis RXNORM Value Set (2.16.840.1.113883.3.117.1.7.1.211)"
- "Medication, Order: Low Dose Unfractionated Heparin for VTE Prophylaxis" using "Low Dose Unfractionated Heparin for VTE Prophylaxis RXNORM Value Set (2.16.840.1.113762.1.4.1045.39)"
- "Medication, Order: Low Molecular Weight Heparin for VTE Prophylaxis" using "Low Molecular Weight Heparin for VTE Prophylaxis RXNORM Value Set (2.16.840.1.113883.3.117.1.7.1.219)"
- "Medication, Order: Warfarin" using "Warfarin RXNORM Value Set (2.16.840.1.113883.3.117.1.7.1.232)"
- "Medication, Order not done: Medical Reason" using "Medical Reason SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.473)"
- "Medication, Order not done: Patient Refusal" using "Patient Refusal SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.93)"
- "Procedure, Performed: General or Neuraxial Anesthesia" using "General or Neuraxial Anesthesia Grouping Value Set (2.16.840.1.113883.3.666.5.1743)"
- "Procedure, Performed: General Surgery" using "General Surgery Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.255)"
- "Procedure, Performed: Gynecological Surgery" using "Gynecological Surgery Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.257)"
- "Procedure, Performed: Hip Fracture Surgery" using "Hip Fracture Surgery Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.258)"
- "Procedure, Performed: Hip Replacement Surgery" using "Hip Replacement Surgery Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.259)"
- "Procedure, Performed: Intracranial Neurosurgery" using "Intracranial Neurosurgery Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.260)"
- "Procedure, Performed: Knee Replacement Surgery" using "Knee Replacement Surgery Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.261)"
- "Procedure, Performed: Urological Surgery" using "Urological Surgery Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.272)"
- Attribute: "Diagnosis: Atrial Fibrillation/Flutter" using "Atrial Fibrillation/Flutter Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.202)"
- Attribute: "Result: Low Risk" using "Low Risk SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.400)"
- Attribute: "Ordinality: Principal" using "Principal SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.14)"
- Attribute: "Route: Intravenous route" using "Intravenous route SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.222)"
- Attribute: "Diagnosis: Obstetrics" using "Obstetrics Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.263)"
- Attribute: "Diagnosis: Obstetrics VTE" using "Obstetrics VTE Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.264)"
- Attribute: "Route: Subcutaneous route" using "Subcutaneous route SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.223)"
- Attribute: "Principal diagnosis: Mental Health Diagnoses" using "Mental Health Diagnoses Grouping Value Set (2.16.840.1.113883.3.464.1003.105.12.1004)"
- Attribute: "Principal diagnosis: Ischemic Stroke" using "Ischemic Stroke Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.247)"
- Attribute: "Principal diagnosis: Hemorrhagic Stroke" using "Hemorrhagic Stroke Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.212)"
- Attribute: "Diagnosis: Venous Thromboembolism" using "Venous Thromboembolism Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.279)"
- "Patient Characteristic Ethnicity: Ethnicity" using "Ethnicity CDCREC Value Set (2.16.840.1.114222.4.11.837)"
- "Patient Characteristic Payer: Payer" using "Payer SOP Value Set (2.16.840.1.114222.4.11.3591)"
- "Patient Characteristic Race: Race" using "Race CDCREC Value Set (2.16.840.1.114222.4.11.836)"
- "Patient Characteristic Sex: ONC Administrative Sex" using "ONC Administrative Sex AdministrativeGender Value Set (2.16.840.1.113762.1.4.1)"