Accuracy of postpartum hemorrhage coding in the Swedish Pregnancy Register.
Accuracy of postpartum hemorrhage coding in the Swedish Pregnancy Register.
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DOI：
10.1111/aogs.13994
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发表时间：
2021-03
影响因子：
4.3
通讯作者：
Stephansson O
中科院分区：
文献类型：
--
作者：
Ladfors LV;Muraca GM;Butwick A;Edgren G;Stephansson O
产后出血（PPH）被认为是产科发病率和死亡率的主要原因。全人群研究使用国际疾病分类（ICD）诊断代码来跟踪和报告PPH的患病率。虽然第10次修订（ICD-10）于1997年在瑞典推出，但ICD-10代码用于PPH的准确性尚不清楚。因此，目的是确定瑞典妊娠登记处PPH诊断编码的准确性。我们对2014年至2019年期间瑞典的609807例分娩进行了回顾性队列研究。PPH的ICD-10代码和估计失血量的信息摘自瑞典妊娠登记。使用估计失血量>1000 mL作为参考标准，我们通过估计灵敏度、特异性、阳性预测值和阴性预测值以及精确的二项式95%置信区间（CI），评价了ICD-10编码对PPH诊断的准确性。在我们的二次分析中，我们评估了ICD-10对重度PPH的编码准确性，重度PPH定义为估计失血量>1000 mL，并且在斯堪的纳维亚献血和输血数据库中登记的红细胞输注至少1个单位。在609807例分娩中，43312例（7.1%）的ICD-10编码为PPH，45071例（7.4%）的估计失血量>1000 mL。ICD编码的敏感性为88.5%（95% CI 88.2 - 88.7），特异性为99.4%（95% CI 99.4 - 99.4），阳性预测值为92.0%（95% CI 91.8 - 92.3），阴性预测值为99.1%（95% CI 99.1 - 99.1）。在我们的二次分析中，对于重度PPH分娩，ICD编码的敏感性为91.3%（95% CI 90.7 - 91.9），而特异性为83.5%（95% CI 82.3 - 84.6）。我们的研究结果表明，瑞典PPH的ICD-10编码具有中等高的敏感性和良好的特异性。这些结果表明，PPH诊断代码的医疗记录和相关的怀孕和出生登记，可用于研究，提高质量和报告PPH患病率在瑞典。
Postpartum hemorrhage (PPH) is recognized as a leading cause of obstetric morbidity and mortality. Population‐wide studies have used International Classification of Diseases (ICD) diagnostic codes to track and report the prevalence of PPH. Although the 10th revision (ICD‐10) was introduced in Sweden in 1997, the accuracy of ICD‐10 codes for PPH is not known. Thus, the aim was to determine the accuracy of diagnostic coding for PPH in the Swedish Pregnancy Register. We performed a retrospective cohort study of 609 807 deliveries in Sweden between 2014 and 2019. Information on ICD‐10 codes for PPH and estimated blood loss were extracted from the Swedish Pregnancy Register. Using an estimated blood loss >1000 mL as the reference standard, we evaluated the diagnostic accuracy of ICD‐10 codes for PPH by estimating sensitivity, specificity, positive predictive value and negative predictive value with exact binomial 95% confidence intervals (CIs). In our secondary analysis, we assessed the ICD‐10 coding accuracy for severe PPH, defined as an estimated blood loss >1000 mL and transfusion of at least 1 unit of red blood cells registered in the Scandinavian Donations and Transfusion database. Of the 609 807 deliveries, 43 312 (7.1%) had an ICD‐10 code for PPH and 45 071 (7.4%) had an estimated blood loss >1000 mL. The ICD codes had a sensitivity of 88.5% (95% CI 88.2‐88.7), specificity of 99.4% (95% CI 99.4‐99.4), positive predictive value of 92.0% (95% CI 91.8‐92.3) and negative predictive value of 99.1% (95% CI 99.1‐99.1). In our secondary analysis, on deliveries with severe PPH, the sensitivity for an ICD code was 91.3% (95% CI 90.7‐91.9), whereas specificity was 83.5% (95% CI 82.3‐84.6). Our findings indicate that ICD‐10 codes for PPH in Sweden have moderately high sensitivity and excellent specificity. These results suggest that PPH diagnostic codes in medical records and linked pregnancy and birth registers can be used for research, quality improvement and reporting PPH prevalence in Sweden.
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影响因子：
7.2
作者：
Miller, Russell S.;Kuller, Jeffrey A.
通讯作者：
Kuller, Jeffrey A.
影响因子：
4.3
作者：
Stephansson, Olof;Petersson, Kerstin;Wikstrom, Anna-Karin
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Wikstrom, Anna-Karin
影响因子：
9.8
作者：
Main, Elliott K.;Cape, Valerie;Gould, Jeffrey B.
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影响因子：
2.9
作者：
Butwick, Alexander J.;Walsh, Eileen M.;Escobar, Gabriel J.
通讯作者：
Escobar, Gabriel J.
DOI：
10.1111/j.1471-0528.2011.03198.x
发表时间：
2012-02-01
影响因子：
5.8
作者：
Lutomski, J. E.;Byrne, B. M.;Greene, R. A.
通讯作者：
Greene, R. A.