Use of Hospital Episode Statistics to investigate abdominal aortic aneurysm surgery
Use of Hospital Episode Statistics to investigate abdominal aortic aneurysm surgery
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DOI：
10.1002/bjs.7772
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发表时间：
2012-01-01
影响因子：
9.6
通讯作者：
van der Meulen, J.
中科院分区：
文献类型：
--
作者：
Johal, A.;Mitchell, D.;van der Meulen, J.
背景：评估了编码框架，以研究英国医院发作统计 (HES) 数据库中接受腹主动脉瘤 (AAA) 开放手术置换的患者。目的是建立在诊断、预后和治疗方面均质的患者群体。 方法：对 2003 年 4 月至 2008 年 3 月期间英国国家卫生服务医院收治的患者进行潜在相关诊断（国际疾病分类，第 10 版）和程序（人口普查和调查办公室分类，第 4 版）代码的频率和一致性评估。将管理代码与诊断和程序代码进行比较，以检查因破裂而接受紧急手术的患者AAA 被紧急收治。结果：在 20 290 名接受 AAA 置换的患者中，19 250 名（94.9%）的诊断一致（未破裂或破裂的 AAA）； 79.3% 接受紧急置换的患者被编码为破裂的 AAA，而接受非紧急置换的患者中 95.7% 的患者被编码为未破裂的 AAA。在接受紧急置换破裂 AAA 的患者中，93.3% 的患者被编码为急诊入院。结论：编码一致性很高。拟议的框架可以通过结合诊断、程序和管理代码来定义同质群体。它还允许在国家和医院层面评估潜在的错误编码。
Background: A coding framework was evaluated to study patients undergoing open surgical replacement of an abdominal aortic aneurysm (AAA) in the English Hospital Episode Statistics (HES) database. The objective was to create groups of patients who are homogeneous with respect to diagnosis, prognosis and treatment.Methods: The frequency and consistency of potentially relevant diagnosis (International Classification of Diseases, 10th revision) and procedure (Office of Population Censuses and Surveys Classification, 4th revision) codes were assessed in patients admitted to English National Health Service hospitals between April 2003 and March 2008. Administrative codes were compared with diagnosis and procedure codes to check that patients who had undergone emergency surgery for a ruptured AAA were admitted as an emergency.Results: Of 20 290 patients undergoing AAA replacement, 19 250 (94.9 per cent) had a consistent diagnosis (unruptured or ruptured AAA); 79.3 per cent of patients with an emergency replacement were coded as having a ruptured AAA and 95.7 per cent of those with a non-emergency replacement as having an unruptured AAA. Of patients who had undergone emergency replacement of a ruptured AAA, 93.3 per cent were coded as having been admitted as an emergency.Conclusion: Coding consistency was high. The proposed framework could define homogeneous groups by combining diagnosis, procedure and administrative codes. It also allows an assessment of potential miscoding at national and hospital level.