Rates in Severe Morbidity Indicators per 10,000 Delivery Hospitalizations, 1993–2014

Rates in Severe Morbidity Indicators per 10,000 Delivery Hospitalizations, 1993–2014
SMM indicator Rate per 10,000 delivery hospitalizations
1993
N weighted = 18,386
1994 1997 1998 2001 2002 2005 2006 2009 2010 2013 2014
N weighted = 54,750
Percentage change from 1993 to 2014
1. Blood transfusions 24.5 27.4 30.2 35.2 44.8 49.4 75.4 79.3 101.9 111.3 118.5 122.3 399.2
2,3. Acute myocardial infarction/Aneurysm 0.1 0.1 0.1 0.1 0.2 0.1 0.3 0.2 0.2 0.3 0.3 0.2 100
4. Acute renal failure 1.3 1.2 1.7 1.8 1.7 1.8 2.3 2.7 3.6 4.2 5.0 5.2 300
5. Adult respiratory distress syndrome 2.0 2.4 2.6 2.8 2.8 2.9 4.0 4.1 5.1 6.0 5.3 6.1 205
6,7. Cardiac arrest, fibrillation/Conversion of cardiac rhythm 0.4 0.7 0.8 0.7 0.6 0.7 1.1 0.9 1.0 1.2 1.0 1.1 175
8. Shock 1.1 0.9 1.0 1.1 0.9 1.1 1.6 1.6 2.3 2.4 2.5 3.0 172.7
9,10. Ventilation/Temporary tracheostomy 4.1 4.4 5.0 4.9 4.7 5.1 5.4 5.4 6.7 7.5 6.6 7.9 92.7
11. Sepsis 2.4 2.2 2.2 2.2 1.8 2.0 2.1 2.2 2.5 2.6 3.1 4.2 75
12. Hysterectomy 6.9 6.7 7.6 7.2 7.5 7.6 8.0 8.2 9.3 8.6 10.6 10.7 55.1
13. Disseminated intravascular coagulation 6.0 5.6 6.0 5.6 5.3 6.4 7.2 7.0 7.2 8.2 7.6 7.2 20
14. Air and thrombotic embolism 0.8 0.5 0.6 0.4 0.8 1.0 1.2 1.1 1.1 1.1 0.9 0.9 12.5
15. Amniotic fluid embolism 0.2 0.3 0.4 0.2 0.3 0.3 0.5 0.3 0.3 0.4 0.3 0.2 0
16. Acute congestive heart failure or pulmonary edema 2.6 3.1 3.7 3.3 3.3 3.2 3.8 3.8 2.9 2.9 2.7 2.4 -7.7
17. Puerperal cerebrovascular disorders 1.3 1.4 1.4 1.6 1.2 1.6 1.6 1.6 1.1 1.1 1.1 0.9 -30.8
18. Heart failure or arrest during surgery or procedure 0.5 0.7 0.5 0.6 0.4 0.6 0.5 0.8 0.6 0.5 0.3 0.3 -40
19. Eclampsia 4.1 3.7 3.6 4.0 4.0 3.8 4.1 3.5 3.0 2.6 2.2 2.0 -51.2
20. Severe anesthesia complications 2.3 2.1 1.4 1.5 1.0 1.0 0.9 0.8 0.5 0.5 0.5 0.3 -87
21. Sickle cell disease crisis * * * * * * 0.7 0.6 0.4 0.7 0.5 0.5 N/A
Overall with blood transfusions 49.5 51.8 54.1 59.0 65.1 71.3 97.6 101.7 121.9 133.1 139.0 144.0 190.9
Overall without blood transfusions 28.6 28.3 28.9 28.5 26.8 28.6 31.9 32.1 31.4 33.0 33.7 35.0 22.4

*Data not available

Due to rare prevalence, the following indicators were combined for reporting purposes: 1) Acute myocardial infarction and aneurysm; 2) cardiac arrest/ventricular fibrillation and conversion of cardiac rhythm; and 3) temporary tracheostomy and ventilation. This table shows the rates of all 21 SMM indicators from 1993 through 2014 for selected years per 10,000 delivery hospitalizations. Compared with the 1993 period, the following SMM indicators had substantial (50% and more) rate increases in 2014:

  • Blood transfusions at 399%.
  • Acute renal failure at 300%.
  • Adult respiratory distress syndrome at 205%.
  • Cardiac arrest, fibrillation, or conversion of cardiac rhythm at 175%.
  • Shock at 173%.
  • Acute myocardial infarction or aneurysm at 100%.
  • Ventilation/temporary tracheostomy at 93%.
  • Sepsis at 75%.
  • Hysterectomy at 55%.

Rates did not increase substantially or decreased among the following eight indicators:

  • Disseminated intravascular coagulation.
  • Air and thrombotic embolism.
  • Amniotic fluid embolism.
  • Acute congestive heart failure or pulmonary edema.
  • Puerperal cerebrovascular disorders.
  • Heart failure or arrest during surgery or procedure.
  • Eclampsia
  • Severe anesthesia complications.