Accuracy of ICD-9 coding for Clostridium difficile infections:: a retrospective cohort
Accuracy of ICD-9 coding for Clostridium difficile infections:: a retrospective cohort
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DOI：
10.1017/s0950268806007655
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发表时间：
2007-08-01
影响因子：
4.2
通讯作者：
Schnipper, J. L.
中科院分区：
文献类型：
--
作者：
Scheurer, D. B.;Hicks, L. S.;Schnipper, J. L.
艰难梭菌（C. diff）是一个主要的医院问题。该疾病的流行病学监测可通过微生物学或行政管理数据来完成。微生物追踪是有问题的，因为它并不总是转化为临床疾病，而且并不总是可用的。通过管理数据进行跟踪是有吸引力的，但ICD-9编码对C. diff的准确性尚不清楚。本研究通过对住院C. dff患者的大型管理数据库（通过ICD-9编码或细胞毒测定），发现ICD-9编码的敏感性、特异性、阳性预测值和阴性预测值分别为71%、99%、87%和96%（以微观数据为金标准）。当仅使用有症状的患者时，敏感性增加到82%，当仅使用出院时可获得检测结果的有症状的患者时，敏感性增加到88%。艰难梭菌ICD-9编码非常接近真实的艰难梭菌感染，特别是在出院时可获得检测结果的有症状患者中，因此可作为微生物学数据的合理替代方法用于跟踪目的。
Clostridium difficile (C. diff) is a major nosocomial problem. Epidemiological surveillance of the disease can be accomplished by microbiological or administrative data. Microbiological tracking is problematic since it does not always translate into clinical disease, and it is not always available. Tracking by administrative data is attractive, but ICD-9 code accuracy for C. diff is unknown. By using a large administrative database of hospitalized patients with C. dff (by ICD-9 code or cytotoxic assay), this study found that the sensitivity, specificity, positive, and negative predictive values of ICD-9 coding were 71%, 99%, 87%, and 96% respectively (using micro data as the gold standard). When only using symptomatic patients the sensitivity increased to 82% and when only using symptomatic patients whose test results were available at discharge, the sensitivity increased to 88%. C. diff ICD-9 codes closely approximate true C. diff infection, especially in symptomatic patients whose test results are available at the time of discharge, and can therefore be used as a reasonable alternative to microbiological data for tracking purposes.