California Postoperative Sepsis Outcomes for Inpatient Elective Surgeries

In 2021, 1,054 adult patients developed postoperative sepsis in California hospitals, following an elective surgery. With improvement in care quality, these in-hospital complications may have been avoided. 

Why is the Postoperative Sepsis Indicator Important?

The Postoperative Sepsis Indicator, as part of the Patient Safety Indicators (PSIs), is developed by the federal Agency for Healthcare Research and Quality (AHRQ) as a measure of adult patients who developed sepsis in hospital following elective surgeries. This Postoperative Sepsis Indicator, along with the other PSIs, focuses on potentially avoidable in-hospital complications and adverse events that represent opportunities for improvement in the delivery of care. The results provide risk-adjusted hospital rates and performance ratings on postoperative sepsis. Hospitals can utilize the report to improve quality of care and patients can use it to make informed health care decisions.

Which Hospitals Have Above Average and Below Average Postoperative Sepsis Rates?

Hospitals were rated “Above Average”, “Average”, or “Below Average” by comparing their risk-adjusted postoperative sepsis rates with the overall state rates. Risk adjustment is a statistical methodology that takes into account a patient’s age, sex, underlying health conditions, and surgeries the patient has undergone. The majority of hospitals were rated “Average”, indicating their postoperative sepsis rates were not significantly different than the state average. Hospitals with a higher postoperative sepsis rate are distinguished from those with a lower rate, indicating opportunities for health care quality improvement.

Key Findings

  • The postoperative sepsis rate for California hospitals in 2021 was 0.48 percent (1,054 cases from 219,063 adult patients undergoing elective surgeries) while the rate was 0.53 percent (1,197 cases from 226,512 elective surgeries) in 2020 and 0.44 percent in 2019 (1,328 cases from 299,027 elective surgeries).
  • In 2021, of the 295 hospitals that were assigned a risk-adjusted rate and performance rating, eight hospitals (2.7 percent) were rated “Above Average”, 12 hospitals (4.1 percent) were rated “Below Average”, and 275 hospitals (93.2 percent) were rated as “Average”.
  • In 2019 and 2020, 302 and 294 hospitals were assigned a risk-adjusted rate and performance rating respectively.  Of those, 11 hospitals (3.6 percent) in 2019 and 12 hospitals (4.1 percent) in 2020 were rated “Above Average”, and 13 hospitals (4.3 percent) in 2019 and 14 hospitals (4.8 percent) in 2020 were rated “Below Average”.  There were 278 hospitals (92.1 percent) in 2019 and 268 hospitals (91.2 percent) in 2020 rated as “Average”.

The visualization below shows hospitals’ postoperative rates and ratings for 2019, 2020, and 2021. The Rating filter allows the user to select a performance category (“Above Average”, “Below Average”, or “Average”) to view the hospitals in that category. Changes have been made to the Agency for Healthcare Research and Quality (AHRQ) software and measure specifications over the past few years; therefore, exact comparisons between years should be interpreted with caution. 

Postoperative Sepsis Outcomes for Inpatient Elective Surgery Rates and Ratings

Note: Hospitals with fewer than three patients discharged with elective surgeries were excluded from reporting due to the AHRQ methodological requirement.

Understanding the Data

Additional Information

Topic: Healthcare Quality
Source Link: Healthcare Quality – AHRQ Quality Indicators
Citation: HCAI – AHRQ Quality Indicators – Postoperative Sepsis Outcomes for Elective Surgeries in California Hospitals, 2019-2021
Temporal Coverage: 2019-2021
Spatial/Geographic Coverage: Statewide, County
Frequency: Annual