By: James Pitt  Jun. 20, 2018
Venous thromboembolism (VTE) is a condition in which a blood clot forms in a vein, then may dislodge and block blood supply elsewhere. VTE is a common comorbidity of sepsis. The Surviving Sepsis Campaign recommends that patients with severe sepsis receive daily prophylaxis against VTE, with both pharmacologic therapy and pneumatic compression devices when possible.
Following Dexur's examination of ICU stays among severe sepsis patients with and without VTE in Massachusetts, analysts examined mortality among severe sepsis patients with and without VTE in California. The sample was patients with sepsis with major complications or comorbidities (MCC) without mechanical ventilation (DRG 871) among CMS inpatient discharges from 2013-2016. At all hospitals examined, mortality with sepsis and VTE was higher than mortality with sepsis without VTE.
The largest gap was at Enloe Medical Center (Chico, CA), where 33% of DRG 871 sepsis patients with VTE died in-hospital, while only 18% of those without VTE died in-hospital. The smallest gap was at Memorial Medical Center (Modesto, CA), where the respective rates were 16% and 15%. There was greater variation in mortality rates with VTE than without VTE. This may suggest that some hospitals have an opportunity to reduce their overall sepsis mortality rates by targeting VTE.
On average, a DRG 871 patient with VTE at one of these eight hospitals was about 1.5 times more likely to die in the hospital than a DRG 871 patient without VTE. The odds ratio of mortality in such patients with and without VTE varied from 2.24 at Enloe Medical Center to 1.08 at Memorial Medical Center.
From 2013-2016, for DRG 871 (SEPTICEMIA OR SEVERE SEPSIS W/O MV 96+ HOURS W MCC) at the following hospitals: