Establishing a composite neonatal adverse outcome indicator using English hospital administrative data
Establishing a composite neonatal adverse outcome indicator using English hospital administrative data
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DOI：
10.1136/archdischild-2018-315147
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发表时间：
2019-09-01
影响因子：
4.4
通讯作者：
Cromwell, David A.
中科院分区：
文献类型：
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作者：
Knight, Hannah Ellin;Oddie, Sam J.;Cromwell, David A.
目的采用起源于澳大利亚的新生儿不良结局综合指标(NAOI)，并在英文医院管理数据中评价其作为结局指标的可行性和有效性。设计我们使用医院流行病学统计(HES)数据，其中包含2014年4月1日至2015年3月31日期间在英国国民健康服务(NHS)出生的婴儿的信息。澳大利亚的NAOI被映射到HES中使用的诊断和程序代码，并进行了修改，以反映英国的数据质量和新生儿健康问题。为了考察英语NAOI(E-NAOI)的同时效度，我们比较了NAOI成分的比率和基于人群的研究。为了研究E-NAOI的预测有效性，计算了有和没有E-NAOI成分的婴儿第一年的再住院率和死亡率。结果在这段时间内出生的600963名符合条件的婴儿中，有484007名(81%)被纳入分析。114/148家NHS信托基金通过了数据质量检查，并被纳入分析。改良的E-NAOI包括23个组成部分(16个诊断和7个程序)。在活产婴儿中，5.4%的婴儿在出院前至少记录了一种E-NAOI成分。在活着出院的新生儿中，E-NAOI与显著更高的死亡风险相关(0.81%比0.05%；p
Objective We adapted a composite neonatal adverse outcome indicator (NAOI), originally derived in Australia, and assessed its feasibility and validity as an outcome indicator in English administrative hospital data. Design We used Hospital Episode Statistics (HES) data containing information infants born in the English National Health Service (NHS) between 1 April 2014 and 31 March 2015. The Australian NAOI was mapped to diagnoses and procedure codes used within HES and modified to reflect data quality and neonatal health concerns in England. To investigate the concurrent validity of the English NAOI (E-NAOI), rates of NAOI components were compared with population-based studies. To investigate the predictive validity of the E-NAOI, rates of readmission and death in the first year of life were calculated for infants with and without E-NAOI components. Results The analysis included 484 007 (81%) of the 600 963 eligible babies born during the timeframe. 114/148 NHS trusts passed data quality checks and were included in the analysis. The modified E-NAOI included 23 components (16 diagnoses and 7 procedures). Among liveborn infants, 5.4% had at least one E-NAOI component recorded before discharge. Among newborns discharged alive, the E-NAOI was associated with a significantly higher risk of death (0.81% vs 0.05%; p