Imaging Use and VTE Event Rates – supplemental tables 1 2 Page 1 of 5 SUPPLEMENTAL TABLES Supplemental table 1: 11 procedures as identified by International Classification of Diseases, Ninth Revision [ICD-9] codes and American Medical Association Current Procedural Terminology [CPT] codes. Surgery type ICD-9 codes CPT codes Colon resection 17.3, 17.31, 17.32, 17.33, 17.34, 17.35, 17.36, 17.39, 45.7, 45.71, 45.72, 45.73, 45.74, 45.75, 45.76, 45.79, 45.8, 45.81, 45.82, 45.83 44025, 44139, 44140, 44141, 44143, 44144, 44145, 44146, 44147, 44150, 44151, 44160, 44180, 44187, 44188, 44204, 44205, 44206, 44207, 44208, 44210, 44213, 44227, 44238, 44310, 44312, 44314, 44316, 44320, 44322, 44340, 44345, 44346, 44604, 44605, 44620, 44625, 44626, 44660, 44661, 44680, 44700, 44799, 45805, 45825 Bariatric surgery 44.31, 44.38, 44.39; 278.01, 278.00, 289.0, 278.1, 278.8 43644, 43645, 43770, 43771, 43772, 43773, 43774, 43775, 43842, 43843, 43845, 43846, 43847, 43848, 43886, 43887, 43888 Rectal surgery 48.4, 48.40, 48.41, 48.42, 48.43, 48.49, 48.5, 48.50, 48.51, 48.52, 48.59, 48.6, 48.61, 48.62, 48.63, 48.64, 48.65, 48.69 0184T, 44155, 44156, 44157, 44158, 44211, 44212, 45000, 45005, 45020, 45108, 45110, 45111, 45112, 45113, 45114, 45116, 45119, 45120, 45121, 45123, 45126, 45130, 45135, 45136, 45150, 45160, 45170, 45190, 45395, 45397, 45400, 45402, 45499, 45505, 45540, 45541, 45550, 45560, 45800, 45820, 45905, 45910, 45999, 46040, 46045, 46060, 46700, 46706, 46710, 46712, 46715, 46740, 46744, 46750, 46753, 46760, 46761, 46762, 46940, 46942, 46947, 46999 Total knee reconstruction arthroplasty Abdominal aortic aneurysm repair 81.54, 81.55 27440, 27441, 27442, 27443, 27445, 27446, 27447, 27486, 27487 38.34, 38.44, 38.64, 39.25, 39.71; 441.4, 441.9 34800, 34802, 34803, 34804, 34805, 34825, 34830, 34831, 34832, 35081, 35082, 35091, 35092, 35102, 35103 Esophagectomy 42.4, 42.40, 42.41, 42.42, 43.99 39502, 43030, 43045, 43100, 43101, 43107, 43108, 43112, 43113, 43116, 43117, 43118, 43121, 43122, 43123, 43124, 43130, 43135, 43279, 43280, 43281, 43282, 43289, 43300, 43305, 43310, 43312, 43313, 43320, 43324, 43325, 43326, 43330, 43331, 43340, 43341, 43351, 43352, 43360, 43361, 43405, 43410, 43415, 43420, 43425, 43496 Pancreatectomy 52.5, 52.51, 52.52, 52.53, 52.59, 52.6, 52.7 48000, 48100, 48105, 48120, 48140, 48145, 48146, 48148, 48150, 48152, 48153, 48154, 48155, 48160, 48500, 48510, 48511, 48520, 48540, 48545, 48547, 48548, 48999 Coronary artery bypass graft [CABG] 36.10, 36.11, 36.12, 36.13, 36.14, 36.15, 36.16, 36.17, 36.19 33508, 33510, 33511, 33512, 33513, 33514, 33516, 33517, 33518, 33519, 33521, 33522, 33523, 33530, 33533, 33534, 33535, 33536, 33572, 4110F Imaging Use and VTE Event Rates – supplemental tables Lung resection Brain tumor resection Cystectomy 3 4 32.3, 32.30, 32.39, 32.4, 32.41, 32.49, 32.5, 32.50, 32.59, 32.1x, 32.29 32.3x, 32.5x, 32.4x 01.51, 01.59, 01.6, 04.01, 07.59, 07.61, 07.62 07.63, 07.64, 07.65, 07.68, 07.69, 38.31, 38.32, 38.41, 38.81, 38.82, 39.28, 01.21, 01.23, 01.24, 01.25, 01.31, 01.32, 01.39 57.6, 57.7, 57.71, 57.79 Page 2 of 5 32440, 32442, 32445, 32480, 32482, 32484, 32486, 32488, 32491, 32503, 32504, 32663 61510, 61512, 61518, 61519, 61520, 61521, 61526, 61530, 61545, 61546 51550, 51555, 51565, 51570, 51575, 51580, 51585, 51590, 51595, 51596, 51597 Imaging Use and VTE Event Rates – supplemental tables Page 3 of 5 Supplemental table 2: DVT/PE/VTE imaging identified using the Healthcare Common Procedure Coding System [HCPCS] codes in the Inpatient and Outpatient Revenue Center and Carrier Line Item files and the ICD-9-CM procedure codes. Imaging study DVT imaging Venous duplex PE imaging Chest CT Chest MRI Ventilation-Perfusion scan Venogram VTE imaging any of above 5 6 HCPCS codes ICD-9-CM procedure codes 93970, 93971 8877 71260, 71250, 71270, 71275 71550, 71551,l 71552, 71555 78585, 78584, 78580,l 78599, 78598, 78597, 78582 75741, 75743, 75746, 75820, 75822, 78445, 78456, 78457, 78458 8843 any of above any of above 9215 8866 Imaging Use and VTE Event Rates – supplemental tables 7 8 9 Page 4 of 5 Supplemental table 3: (A) DVT event rates captured at 30-days and while inpatient only examined across DVT imaging use rate quartiles. (B) PE event rates captured at 30-days and while inpatient only examined across PE imaging use rate quartiles. P-value (A) DVT imaging use rate quartiles for trend Quartile 1 Quartile 2 Quartile 3 Quartile 4 (Cuzick extension Number of hospitals 52 52 52 52 of Wilcoxon) DVT imaging use rate Mean Standard deviation 7.29% * 0.84% 12.09% 2.90% <0.001 1.07% 0.73% 1.49% 0.98% 0.003 0.81% * 1.19% 0.64% 1.54% Inpatient only events 1.04% 0.68% 1.35% 0.76% 0.003 0.49% * 0.52% 0.84% 1.64% 0.67% 0.58% 1.09% 0.78% <0.001 0.48% 0.46% 0.96% 1.86% 0.62% 0.48% 1.00% 0.66% <0.001 3.22% * 1.11% 5.20% * 0.52% 30-days events Observed DVT event rate Mean Standard deviation Risk-adjusted DVT event rate Mean Standard deviation 0.82% * 0.71% 1.15% 1.64% Observed DVT event rate Mean Standard deviation Risk-adjusted DVT event rate Mean Standard deviation (B) Quartile 1 Number of hospitals 52 PE imaging use rate quartiles Quartile 2 Quartile 3 52 Quartile 4 P-value for trend (Cuzick extension of Wilcoxon) 52 52 4.69% * 0.44% 7.00% 1.51% <0.001 0.69% 0.43% 0.78% 0.73% <0.001 0.68% 0.40% 0.70% 0.62% <0.001 0.42% 0.36% 0.53% 0.65% <0.001 PE imaging use rate Mean Standard deviation 2.18% * 0.68% 3.55% * 0.36% 30-days events Observed PE event rate Mean Standard deviation Risk-adjusted PE event rate Mean Standard deviation 0.43% * 0.45% 0.46% * 0.38% 0.41% * 0.45% * 0.35% 0.35% Inpatient only events Observed PE event rate 10 11 Mean 0.22% * 0.27% * Standard deviation 0.36% 0.31% Risk-adjusted PE event rate Mean 0.21% * 0.26% Standard deviation 0.23% 0.28% * P <0.05, 2-tailed test for difference in means compared with VTE Bonferroni correction for multiple pairwise comparisons. 0.002 0.42% 0.45% 0.35% 0.53% imaging use rate quartile 4 mean after Imaging Use and VTE Event Rates – supplemental tables 12 13 14 15 16 17 Supplemental table 4: (A) Multivariable linear regression of risk-adjusted rates showing the association between DVT imaging rate quartiles and risk-adjusted DVT event rate captured at 30-days and while inpatient only. (B) Multivariable linear regression of risk-adjusted rates showing the association between PE imaging rate quartiles and risk-adjusted PE event rate captured at 30-days and while inpatient only. (A) Parameter estimate 30-days events Bed size >= 500 0.01968 COTH † -0.00780 Other teaching ‡ -0.26565 Number of structure quality characteristics # -0.00330 DVT imaging use rate quartile 2 0.42053 DVT imaging use rate quartile 3 0.26532 DVT imaging use rate quartile 4 0.60336 Inpatient only events Bed size >= 500 -0.03568 COTH † 0.01864 Other teaching ‡ -0.31797 Number of structure quality characteristics # -0.01445 DVT imaging use rate quartile 2 0.52339 DVT imaging use rate quartile 3 0.17624 DVT imaging use rate quartile 4 0.60179 Standard error P-value 0.16779 0.19058 0.21225 0.07188 0.19879 0.19880 0.20329 0.907 0.967 0.212 0.963 0.036 0.184 0.003 0.17858 0.20283 0.22590 0.07650 0.21157 0.21159 0.21637 0.842 0.927 0.161 0.850 0.014 0.406 0.006 Parameter estimate 30-days events Bed size >= 500 -0.04127 COTH † 0.00777 Other teaching ‡ -0.18165 Number of structure quality characteristics # 0.04760 PE imaging use rate quartile 2 0.02148 PE imaging use rate quartile 3 0.27428 PE imaging use rate quartile 4 0.27887 Inpatient only events Bed size >= 500 -0.00416 COTH † 0.07741 Other teaching ‡ -0.08262 Number of structure quality characteristics # -0.00959 PE imaging use rate quartile 2 0.04253 PE imaging use rate quartile 3 0.20075 PE imaging use rate quartile 4 0.23793 Standard error P-value 0.07653 0.08511 0.09464 0.03249 0.09139 0.09232 0.09163 0.590 0.927 0.056 0.145 0.815 0.003 0.003 0.06308 0.07015 0.07800 0.02678 0.07532 0.07609 0.07552 0.948 0.271 0.291 0.721 0.573 0.009 0.002 Hospital characteristics 18 19 (B) Hospital characteristics 20 21 22 23 24 25 26 27 28 29 Page 5 of 5 † COTH: member of Council of Teaching Hospitals and Health Systems of the Association of American Medical Colleges [AAMC] ‡ Other teaching: residency training approval from Accreditation Council for Graduate Medical Education [ACGME], or medical school affiliation with American Medical Association [AMA], or American Osteopathic Association [AOA]. # Summation of structure quality characteristics from Joint Commission [JCAHO] accreditation, American College of Surgeons [ACS] Commission on Cancer [CoC] accreditation, level I trauma center certification, burn care service, and/or transplant service.