Using hospital discharge data for determining neonatal morbidity and mortality: a validation study.
Using hospital discharge data for determining neonatal morbidity and mortality: a validation study.
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DOI：
10.1186/1472-6963-7-188
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发表时间：
2007-11-20
影响因子：
2.8
通讯作者：
NICUS group
中科院分区：
文献类型：
--
作者：
Ford JB;Roberts CL;Algert CS;Bowen JR;Bajuk B;Henderson-Smart DJ;NICUS group
尽管新生儿出院数据被广泛使用，但很少有关于新生儿诊断或程序代码的人群健康数据准确性的公开报道。本研究的目的是评估使用常规收集的出院数据，以确定新生儿发病率在出生入院时，从全州范围内的审计选定的新生儿重症监护（NICU）入院的数据相比，准确性。1994-1996年，澳大利亚新南威尔士州2，432名新生儿重症监护病房（NICU）新生儿重症监护审核数据与基于人群的关联出院/出生数据的验证研究。计算了12种诊断和6种手术的敏感性、特异性和阳性预测值（PPV）及精确的二项式置信区间。灵敏度范围从漏气引流的37.0%到极低出生体重的97.7%，特异性均超过85%，PPV范围从70.9%到100%。住院死亡率、低出生体重（≤1500 g）、早产儿视网膜病变、呼吸窘迫综合征、胎粪吸入、肺炎、肺动脉高压、选定的重大异常、任何机械通气（包括CPAP）、大手术和动脉导管未闭或坏死性小肠结肠炎手术的准确识别率均超过92%。新生儿一过性呼吸急促和漏气引流的PPV最低，分别为70.9%和83.6%。虽然未充分确定，但常规收集的出院数据对大多数验证项目具有较高的PPV，适用于新生儿发病率的风险因素分析。程序往往比诊断更准确地记录。
Despite widespread use of neonatal hospital discharge data, there are few published reports on the accuracy of population health data with neonatal diagnostic or procedure codes. The aim of this study was to assess the accuracy of using routinely collected hospital discharge data in identifying neonatal morbidity during the birth admission compared with data from a statewide audit of selected neonatal intensive care (NICU) admissions. Validation study of population-based linked hospital discharge/birth data against neonatal intensive care audit data from New South Wales, Australia for 2,432 babies admitted to NICUs, 1994–1996. Sensitivity, specificity and positive predictive values (PPV) with exact binomial confidence intervals were calculated for 12 diagnoses and 6 procedures. Sensitivities ranged from 37.0% for drainage of an air leak to 97.7% for very low birthweight, specificities all exceeded 85% and PPVs ranged from 70.9% to 100%. In-hospital mortality, low birthweight (≤1500 g), retinopathy of prematurity, respiratory distress syndrome, meconium aspiration, pneumonia, pulmonary hypertension, selected major anomalies, any mechanical ventilation (including CPAP), major surgery and surgery for patent ductus arteriosus or necrotizing enterocolitis were accurately identified with PPVs over 92%. Transient tachypnea of the newborn and drainage of an air leak had the lowest PPVs, 70.9% and 83.6% respectively. Although under-ascertained, routinely collected hospital discharge data had high PPVs for most validated items and would be suitable for risk factor analyses of neonatal morbidity. Procedures tended to be more accurately recorded than diagnoses.
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影响因子：
8
作者：
Horbar, JD;Badger, GJ;Soll, RF
通讯作者：
Soll, RF
影响因子：
2.8
作者：
Lydon-Rochelle, MT;Holt, VL;Callaghan, WM
通讯作者：
Callaghan, WM
影响因子：
2.8
作者：
Roberts, Christine L.;Algert, Charles S.;Ford, Jane B.
通讯作者：
Ford, Jane B.
影响因子：
7.2
作者：
ROOS, LL;SHARP, SM;COHEN, MM
通讯作者：
COHEN, MM
影响因子：
2.8
作者：
Holman, Robert C.;Stoll, Barbara J.;Schonberger, Lawrence B.
通讯作者：
Schonberger, Lawrence B.