- Initial Population =
- AND: Age >= 18 year(s) at: Occurrence A of $EncounterInpatient
- AND NOT: Union of:
- "Diagnosis, Active: Venous Thromboembolism (ordinality: Principal)"
- "Diagnosis, Active: Obstetrics VTE (ordinality: Principal)"
- starts during Occurrence A of $EncounterInpatient
- AND: $DiagnosisVTE starts during Occurrence A of $EncounterInpatient
- Denominator =
- AND: "Occurrence A of Diagnostic Study, Order: VTE Diagnostic Test" starts during Occurrence A of $EncounterInpatient
- AND: First: "Occurrence A of Diagnostic Study, Performed: VTE Diagnostic Test (result: VTE Confirmed)" starts during Occurrence A of $EncounterInpatient
- Denominator Exclusions =
- # Comfort measures
- OR: $InterventionComfortMeasures starts during Occurrence A of $EncounterInpatient
- OR: $InterventionComfortMeasures starts during
- "Encounter, Performed: Emergency Department Visit" <= 1 hour(s) ends before or concurrent with start of Occurrence A of $EncounterInpatient
- # VTE present at admission
- OR: "Diagnosis, Active: VTE Suspected" <= 4 day(s) starts before start of Occurrence A of $EncounterInpatient
- OR: Union of:
- "Diagnosis, Active: VTE Suspected"
- $DiagnosisVTE
- starts during
- "Encounter, Performed: Emergency Department Visit" <= 1 hour(s) ends before or concurrent with start of Occurrence A of $EncounterInpatient
- OR: Union of:
- "Diagnosis, Active: VTE Suspected"
- $DiagnosisVTE
- "Occurrence A of Diagnostic Study, Performed: VTE Diagnostic Test"
- <= 1 day(s) starts after start of Occurrence A of $EncounterInpatient
- # Reasons for not administering mechanical and pharmacologic prophylaxis
- OR: Intersection of:
- "Medication, Administered: Direct Thrombin Inhibitor" starts before start of "Occurrence A of Diagnostic Study, Order: VTE Diagnostic Test"
- "Medication, Administered: Direct Thrombin Inhibitor" starts during Occurrence A of $EncounterInpatient
- OR: Intersection of:
- "Medication, Administered: Glycoprotein IIb/IIIa Inhibitors" starts before start of "Occurrence A of Diagnostic Study, Order: VTE Diagnostic Test"
- "Medication, Administered: Glycoprotein IIb/IIIa Inhibitors" starts during Occurrence A of $EncounterInpatient
- OR:
- AND: $NoMedicationVTEProphylaxisMedicalContraindication starts during
- "Encounter, Performed: Emergency Department Visit" <= 1 hour(s) ends before or concurrent with start of Occurrence A of $EncounterInpatient
- AND: $NoDeviceVTEProphylaxisMedicalContraindication starts during
- "Encounter, Performed: Emergency Department Visit" <= 1 hour(s) ends before or concurrent with start of Occurrence A of $EncounterInpatient
- OR:
- AND: Intersection of:
- $NoMedicationVTEProphylaxisMedicalContraindication starts before start of "Occurrence A of Diagnostic Study, Order: VTE Diagnostic Test"
- $NoMedicationVTEProphylaxisMedicalContraindication starts during Occurrence A of $EncounterInpatient
- AND: Intersection of:
- $NoDeviceVTEProphylaxisMedicalContraindication starts before start of "Occurrence A of Diagnostic Study, Order: VTE Diagnostic Test"
- $NoDeviceVTEProphylaxisMedicalContraindication starts during Occurrence A of $EncounterInpatient
- OR: $NoMedicationDeviceVTEProphylaxisPatientRefusal starts during
- "Encounter, Performed: Emergency Department Visit" <= 1 hour(s) ends before or concurrent with start of Occurrence A of $EncounterInpatient
- OR: Intersection of:
- $NoMedicationDeviceVTEProphylaxisPatientRefusal starts before start of "Occurrence A of Diagnostic Study, Order: VTE Diagnostic Test"
- $NoMedicationDeviceVTEProphylaxisPatientRefusal starts during Occurrence A of $EncounterInpatient
- Numerator =
- AND NOT:
- AND: Occurrence A of $MedicationVTEProphylaxis >= 1 day(s) starts before start of "Occurrence A of Diagnostic Study, Order: VTE Diagnostic Test"
- AND: Occurrence A of $MedicationVTEProphylaxis starts during Occurrence A of $EncounterInpatient
- AND NOT:
- AND: "Occurrence A of Medication, Administered: Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment" >= 1 day(s) starts before start of "Occurrence A of Diagnostic Study, Order: VTE Diagnostic Test"
- AND: "Occurrence A of Medication, Administered: Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment" starts during Occurrence A of $EncounterInpatient
- AND NOT:
- AND: Occurrence A of $DeviceVTEProphylaxis >= 1 day(s) starts before start of "Occurrence A of Diagnostic Study, Order: VTE Diagnostic Test"
- AND: Occurrence A of $DeviceVTEProphylaxis starts during Occurrence A of $EncounterInpatient
- Numerator Exclusions =
- Denominator Exceptions =
- Stratification =
- $EncounterInpatient =
- "Encounter, Performed: Encounter Inpatient" satisfies all
- (length of stay <= 120 day(s))
- ends during "Measurement Period"
- $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"
- $DeviceVTEProphylaxis =
- Union of:
- "Device, Applied: Intermittent pneumatic compression devices (IPC)"
- "Device, Applied: Venous foot pumps (VFP)"
- "Device, Applied: Graduated compression stockings (GCS)"
- $InterventionComfortMeasures =
- Union of:
- "Intervention, Order: Comfort Measures"
- "Intervention, Performed: Comfort Measures"
- $DiagnosisVTE =
- Union of:
- "Diagnosis, Active: Venous Thromboembolism"
- "Diagnosis, Active: Obstetrics VTE"
- $NoMedicationVTEProphylaxisMedicalContraindication =
- Union of:
- "Medication, Administered not done: Medical Contraindication" for "Low Dose Unfractionated Heparin for VTE Prophylaxis"
- "Medication, Administered not done: Medical Contraindication" for "Low Molecular Weight Heparin for VTE Prophylaxis"
- "Medication, Administered not done: Medical Contraindication" for "Injectable Factor Xa Inhibitor for VTE Prophylaxis"
- "Medication, Administered not done: Medical Contraindication" for "Warfarin"
- "Medication, Order not done: Medical Contraindication" for "Unfractionated Heparin for VTE prophylaxis ingredient specific"
- "Medication, Order not done: Medical Contraindication" for "Low Molecular Weight Heparin for VTE prophylaxis ingredient specific"
- "Medication, Order not done: Medical Contraindication" for "Injectable factor Xa inhibitor for VTE prophylaxis ingredient specific"
- "Medication, Order not done: Medical Contraindication" for "Warfarin-only ingredient specific"
- $NoDeviceVTEProphylaxisMedicalContraindication =
- Union of:
- "Device, Applied not done: Medical Contraindication" for "Intermittent pneumatic compression devices (IPC)"
- "Device, Applied not done: Medical Contraindication" for "Venous foot pumps (VFP)"
- "Device, Applied not done: Medical Contraindication" for "Graduated compression stockings (GCS)"
- "Device, Order not done: Medical Contraindication" for "Intermittent pneumatic compression devices (IPC)"
- "Device, Order not done: Medical Contraindication" for "Venous foot pumps (VFP)"
- "Device, Order not done: Medical Contraindication" for "Graduated compression stockings (GCS)"
- $NoMedicationDeviceVTEProphylaxisPatientRefusal =
- 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 "Unfractionated Heparin for VTE prophylaxis ingredient specific"
- "Medication, Order not done: Patient Refusal" for "Low Molecular Weight Heparin for VTE prophylaxis ingredient specific"
- "Medication, Order not done: Patient Refusal" for "Injectable factor Xa inhibitor for VTE prophylaxis ingredient specific"
- "Medication, Order not done: Patient Refusal" for "Warfarin-only ingredient specific"
- "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)"
- "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 Contraindication" using "Medical Contraindication SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.412)"
- "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 Contraindication" using "Medical Contraindication SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.412)"
- "Device, Order not done: Patient Refusal" using "Patient Refusal SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.93)"
- "Diagnosis, Active: Obstetrics VTE" using "Obstetrics VTE Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.264)"
- "Diagnosis, Active: Venous Thromboembolism" using "Venous Thromboembolism Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.279)"
- "Diagnosis, Active: VTE Suspected" using "VTE Suspected SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.277)"
- "Diagnostic Study, Order: VTE Diagnostic Test" using "VTE Diagnostic Test Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.276)"
- "Diagnostic Study, Performed: VTE Diagnostic Test" using "VTE Diagnostic Test Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.276)"
- "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)"
- "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)"
- "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: Warfarin" using "Warfarin RXNORM Value Set (2.16.840.1.113883.3.117.1.7.1.232)"
- "Medication, Administered not done: Medical Contraindication" using "Medical Contraindication SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.412)"
- "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 ingredient specific" using "Injectable factor Xa inhibitor for VTE prophylaxis ingredient specific RXNORM Value Set (2.16.840.1.113762.1.4.1021.11)"
- "Medication, Order: Low Molecular Weight Heparin for VTE prophylaxis ingredient specific" using "Low Molecular Weight Heparin for VTE prophylaxis ingredient specific RXNORM Value Set (2.16.840.1.113762.1.4.1021.12)"
- "Medication, Order: Unfractionated Heparin for VTE prophylaxis ingredient specific" using "Unfractionated Heparin for VTE prophylaxis ingredient specific RXNORM Value Set (2.16.840.1.113762.1.4.1021.13)"
- "Medication, Order: Warfarin-only ingredient specific" using "Warfarin-only ingredient specific RXNORM Value Set (2.16.840.1.113762.1.4.1021.10)"
- "Medication, Order not done: Medical Contraindication" using "Medical Contraindication SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.412)"
- "Medication, Order not done: Patient Refusal" using "Patient Refusal SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.93)"
- Attribute: "Route: Subcutaneous route" using "Subcutaneous route SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.223)"
- Attribute: "Result: VTE Confirmed" using "VTE Confirmed SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.407)"
- Attribute: "Ordinality: Principal" using "Principal SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.14)"
- "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)"