Evaluation of the ICD-10 system in coding revascularisation procedures in patients with peripheral arterial disease in England: A retrospective cohort study using national administrative and clinical databases.
Evaluation of the ICD-10 system in coding revascularisation procedures in patients with peripheral arterial disease in England: A retrospective cohort study using national administrative and clinical databases.
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DOI：
10.1016/j.eclinm.2022.101738
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发表时间：
2023-01
影响因子：
15.1
通讯作者：
Cromwell, David A.
中科院分区：
文献类型：
--
作者：
Birmpili, Panagiota;Atkins, Eleanor;Li, Qiuju;Johal, Amundeep S.;Waton, Sam;Williams, Robin;Pherwani, Arun D.;Cromwell, David A.
关键词：
在英国，许多评估医院护理的研究使用医院事件统计（HES）管理数据库。本研究的目的是探讨HES使用的国际疾病分类第10版（ICD-10）系统是否支持评价接受血运重建的外周动脉疾病（PAD）患者接受的护理。这项回顾性队列研究使用了2017年1月1日至2019年12月31日期间在英国接受PAD血运重建的患者记录，这些记录在国家血管登记研究（NVR）中前瞻性收集并与HES相关。由于缺乏同意或入院和手术日期不同，如果患者的NVR记录与HES不匹配，则将其排除在外。使用未加权Kappa统计量以及敏感性和特异性评价NVR中记录的PAD不同表现与HES中记录的ICD-10诊断代码之间的一致性。还评估了NVR和HES之间的性别、年龄、合并症、入院方式以及手术类型和手术侧的一致性。总共有20，603名患者，24，621名住院患者被纳入研究。NVR和HES在患者性别（Kappa = 0.98）、年龄（Kappa = 0.98）、入院方式（Kappa = 0.80）以及手术类型和手术侧（分别为Kappa = 0.92和0.87）方面的一致性极佳。当探索HES的所有诊断视野时，观察到慢性缺血伴组织缺损（Kappa = 0.63）的基本一致性，但慢性缺血不伴组织缺损（Kappa = 0.32）和急性肢体缺血（Kappa = 0.15）的一致性较低。合并症的一致性好坏参半;糖尿病极好（Kappa = 0.82），慢性肺病中度（Kappa = 0.56），慢性肾病（Kappa = 0.56）和缺血性心脏病（Kappa = 0.45），慢性心力衰竭一般（Kappa = 0.35）。目前在HES中使用的诊断ICD-10代码不能准确区分PAD的阶段。因此，使用HES检查PAD患者的护理模式和结局的研究可能存在错误分类偏倚。采用扩展的ICD-10系统或2022年向世界卫生组织成员国发布的ICD-11版本可能会解决这个问题。 ().
Many studies evaluating care in hospitals in England use the Hospital Episode Statistics (HES) administrative database. The aim of this study was to explore whether the International Classification of Diseases 10th Revision (ICD-10) system used by HES supported the evaluation of care received by patients with peripheral arterial disease (PAD) who had revascularisation. This retrospective cohort study used records on patients who had revascularisation for PAD between 1st January 2017 and 31st December 2019 in England, collected prospectively in the National Vascular Registry (NVR) and linked to HES. Patients were excluded if their NVR record did not have a match in HES, due to lack of consent or different admission and procedure dates. Agreement between different presentations of PAD recorded in the NVR and the ICD-10 diagnostic codes recorded in HES was evaluated using the unweighted Kappa statistic and sensitivity and specificity. Agreement between the NVR and HES was also assessed for gender, age, comorbidities, mode of admission, and procedure type and side. In total, 20,603 patients who had 24,621 admissions were included in the study. Agreement between NVR and HES on patient gender (Kappa = 0.98), age (Kappa = 0.98), mode of admission (Kappa = 0.80), and procedure type and side (Kappa = 0.92 and 0.87, respectively) was excellent. When all diagnostic fields in HES were explored, substantial agreement was observed for chronic ischaemia with tissue loss (Kappa = 0.63), but it was lower for chronic ischaemia without tissue loss (Kappa = 0.32) and acute limb ischaemia (Kappa = 0.15). Agreement on comorbidities was mixed; excellent for diabetes (Kappa = 0.82), moderate for chronic lung disease (Kappa = 0.56), chronic kidney disease (Kappa = 0.56), and ischaemic heart disease (Kappa = 0.45) and fair for chronic heart failure (Kappa = 0.35). The diagnostic ICD-10 codes currently used in HES cannot accurately differentiate between stages of PAD. Therefore, studies using HES to examine patterns of care and outcomes for patients with PAD are likely to suffer from misclassification bias. Adopting an extended ICD-10 system or the ICD-11 version released to the World Health Organisation member states in 2022, may overcome this problem. ().
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影响因子：
37.8
作者：
Heikkila, Katriina;Mitchell, David C.;Cromwell, David A.
通讯作者：
Cromwell, David A.
影响因子：
1.9
作者：
LANDIS, JR;KOCH, GG
通讯作者：
KOCH, GG
影响因子：
2.7
作者：
COHEN, J
通讯作者：
COHEN, J
DOI：
10.1093/bjs/znac109
发表时间：
2022-07-15
期刊：
The British journal of surgery
影响因子：
--
作者：
通讯作者：
--
DOI：
10.1016/j.ejvs.2019.05.006
发表时间：
2019-07
期刊：
European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery
影响因子：
--
作者：
Conte MS;Bradbury AW;Kolh P;White JV;Dick F;Fitridge R;Mills JL;Ricco JB;Suresh KR;Murad MH;Aboyans V;Aksoy M;Alexandrescu VA;Armstrong D;Azuma N;Belch J;Bergoeing M;Bjorck M;Chakfé N;Cheng S;Dawson J;Debus ES;Dueck A;Duval S;Eckstein HH;Ferraresi R;Gambhir R;Gargiulo M;Geraghty P;Goode S;Gray B;Guo W;Gupta PC;Hinchliffe R;Jetty P;Komori K;Lavery L;Liang W;Lookstein R;Menard M;Misra S;Miyata T;Moneta G;Munoa Prado JA;Munoz A;Paolini JE;Patel M;Pomposelli F;Powell R;Robless P;Rogers L;Schanzer A;Schneider P;Taylor S;De Ceniga MV;Veller M;Vermassen F;Wang J;Wang S;GVG Writing Group for the Joint Guidelines of the Society for Vascular Surgery (SVS), European Society for Vascular Surgery (ESVS), and World Federation of Vascular Societies (WFVS)
通讯作者：
GVG Writing Group for the Joint Guidelines of the Society for Vascular Surgery (SVS), European Society for Vascular Surgery (ESVS), and World Federation of Vascular Societies (WFVS)