This measure is calculated based on data extracted from the electronic medical record combined with administrative data sources such as professional fee and discharge diagnoses data. This measure is explicitly not based on provider self-attestation.
All anesthetic cases.
1. The creatinine level does not go above 1.5x the baseline creatinine within 7 days post-op
2. The creatinine level does not increase by ≥ 0.3 mg/dL obtained within 48 hours after anesthesia end.
Only valid creatinine values (≥0.2 mg/dL and ≤25.00 mg/dL) used. Method for calculating EGFR dependent on age and availability of patient race data:
Adult patients >18 years old:
Creatinine Lab Concept ID
Ht/Wt MPOG Concept IDs
Race MPOG Concept IDs modified
Acute kidney injury is a serious complication following non-cardiac surgery and is associated with an increased risk of in-hospital mortality. The development of AKI is known to increase patient care demands, accounting for 20% of intensive care unit (ICU) admissions, and significantly increasing hospital cost, length of stay, and mortality. Definitions and classification schema for AKI vary across current literature; most commonly, these include the Risk/Injury/Failure/Loss/End-stage (RIFLE), Acute Kidney Injury Network (AKIN), and Kidney Disease-Improving Global Outcomes (KDIGO) criteria.
To evaluate provider-level risk adjustment we will calculate the observed to expected outcomes ratio (O/E). The O/E is calculated using a logistic regression model and predicts (given a set list of dependent patient and hospital level variables) the expected probability of having a kidney injury. We adjust for surgery risk score, emergent procedures, ASA, gender, age, body mass index, laboratory values, and teaching versus private hospital. Patient specific comorbidities are evaluated as well.