Postoperative Venous Thromboembolism: The More You Look, the More You Find

Postoperative venous thromboembolism (VTE) rates are widely reported metrics that have been incorporated into many quality improvement programs and public reporting initiatives. However, is VTE incidence an accurate measure of quality, reflecting adherence to VTE prophylaxis guidelines?

Researchers examined VTE imaging and event rates from 2009 and 2010 Medicare claims data for almost 1,000,000 surgical discharges (>2700 hospitals) following 11 types of major surgeries. Hospital quality was assessed using VTE prophylaxis and event rates from the Medicare Hospital Compare website. Paradoxically, hospitals with higher rates of VTE prophylaxis adherence were associated with higher rates of VTE events. Hospitals deemed to be of higher quality (e…