Shifts in National Rates of Inpatient Prolapse Surgery Emphasize Current Coding Inadequacies
Shifts in National Rates of Inpatient Prolapse Surgery Emphasize Current Coding Inadequacies
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DOI：
10.1097/spv.0b013e3182254cf1
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发表时间：
2011-07-01
影响因子：
1.6
通讯作者：
Wu, Jennifer M.
中科院分区：
文献类型：
--
作者：
Bradley, Sarah L.;Weidner, Alison C.;Wu, Jennifer M.
目的：本研究旨在评估美国 1998 年与 2007 年相比全国盆腔器官脱垂住院手术的比率、类型和途径。方法：我们使用 1998 年和 2007 年全国住院患者样本，它代表美国医院出院数据的分层随机样本。我们纳入了根据《国际疾病分类》第 9 版临床修订版的诊断和程序代码接受脱垂手术的 20 岁及以上女性。我们计算了每年接受手术的女性人数和发生率。结果：1998年接受脱垂手术的女性总数为92,503人，2007年为113,646人。手术发生率略有上升，从每10万名女性90.8人增加到100.9人。最常见的手术是子宫切除术，约占 1998 年和 2007 年脱垂手术的一半。悬吊手术占 2007 年手术的 18.8%，比 1998 年的 6.1% 有所增加。通过微创途径进行的手术从 1998 年的 4.8% 增加到 2007 年的 9.4%。然而，很难确定许多手术的路径基于当前的 ICD-9 代码。也没有专门指定网状套件手术或微创骶骨阴道固定术的规范。结论：在过去十年中，住院脱垂手术的比率略有增加。暂停程序的比例有所增加；然而，根据当前的 ICD-9 代码很难确定这些程序的路线。这些发现强调 ICD-9 程序代码没有跟上临床实践的变化。
Objective: This study aimed to assess national rates, types, and routes of inpatient surgery for pelvic organ prolapse in the United States in 1998 compared to those in 2007.Methods: We used the 1998 and 2007 Nationwide Inpatient Sample, which represents a stratified, random sample of discharge data from US hospitals. We included women 20 years and older who underwent surgery for prolapse based on diagnosis and procedure codes of the International Classification of Disease, 9th Revision, Clinical Modification. We calculated the number of women undergoing surgery each year and incidence rates.Results: The total number of women undergoing prolapse surgeries was 92,503 in 1998 versus 113,646 in 2007. The incidence rate of surgery increased slightly, from 90.8 to 100.9 per 100,000 women, respectively. The most common procedure was hysterectomy, representing approximately half of prolapse surgeries in 1998 and 2007. Suspension procedures accounted for 18.8% of procedures in 2007, an increase from 6.1% in 1998. Surgeries performed via a minimally invasive route increased from 4.8% in 1998 to 9.4% in 2007. However, it was difficult to determine the route for many procedures based on current ICD-9 codes. There were also no codes that specifically designated mesh kit procedures or minimally invasive sacrocolpopexies.Conclusions: During the last decade, the rate of inpatient prolapse surgery has slightly increased. The proportion of suspension procedures has increased; however, it is difficult to determine the route of these procedures based on current ICD-9 codes. These findings emphasize that ICD-9 procedure codes have not kept up with changes in clinical practice.