Accuracy of surgical complication rate estimation using ICD-10 codes.
Adolescent
Adult
Aged
Aged, 80 and over
Clinical Coding
Female
Humans
International Classification of Diseases
Length of Stay
/ statistics & numerical data
Male
Middle Aged
Norway
/ epidemiology
Operative Time
Postoperative Complications
/ epidemiology
Prospective Studies
Sensitivity and Specificity
Young Adult
Journal
The British journal of surgery
ISSN: 1365-2168
Titre abrégé: Br J Surg
Pays: England
ID NLM: 0372553
Informations de publication
Date de publication:
02 2019
02 2019
Historique:
received:
05
01
2018
revised:
16
05
2018
accepted:
26
07
2018
pubmed:
20
9
2018
medline:
30
7
2019
entrez:
20
9
2018
Statut:
ppublish
Résumé
The ICD-10 codes are used globally for comparison of diagnoses and complications, and are an important tool for the development of patient safety, healthcare policies and the health economy. The aim of this study was to investigate the accuracy of verified complication rates in surgical admissions identified by ICD-10 codes and to validate these estimates against complications identified using the established Global Trigger Tool (GTT) methodology. This was a prospective observational study of a sample of surgical admissions in two Norwegian hospitals. Complications were identified and classified by two expert GTT teams who reviewed patients' medical records. Three trained reviewers verified ICD-10 codes indicating a complication present on admission or emerging in hospital. A total of 700 admissions were drawn randomly from 12 966 procedures. Some 519 possible complications were identified in 332 of 700 admissions (47·4 per cent) from ICD-10 codes. Verification of the ICD-10 codes against information from patients' medical records confirmed 298 as in-hospital complications in 141 of 700 admissions (20·1 per cent). Using GTT methodology, 331 complications were found in 212 of 700 admissions (30·3 per cent). Agreement between the two methods reached 83·3 per cent after verification of ICD-10 codes. The odds ratio for identifying complications using the GTT increased from 5·85 (95 per cent c.i. 4·06 to 8·44) to 25·38 (15·41 to 41·79) when ICD-10 complication codes were verified against patients' medical records. Verified ICD-10 codes strengthen the accuracy of complication rates. Use of non-verified complication codes from administrative systems significantly overestimates in-hospital surgical complication rates.
Sections du résumé
BACKGROUND
The ICD-10 codes are used globally for comparison of diagnoses and complications, and are an important tool for the development of patient safety, healthcare policies and the health economy. The aim of this study was to investigate the accuracy of verified complication rates in surgical admissions identified by ICD-10 codes and to validate these estimates against complications identified using the established Global Trigger Tool (GTT) methodology.
METHODS
This was a prospective observational study of a sample of surgical admissions in two Norwegian hospitals. Complications were identified and classified by two expert GTT teams who reviewed patients' medical records. Three trained reviewers verified ICD-10 codes indicating a complication present on admission or emerging in hospital.
RESULTS
A total of 700 admissions were drawn randomly from 12 966 procedures. Some 519 possible complications were identified in 332 of 700 admissions (47·4 per cent) from ICD-10 codes. Verification of the ICD-10 codes against information from patients' medical records confirmed 298 as in-hospital complications in 141 of 700 admissions (20·1 per cent). Using GTT methodology, 331 complications were found in 212 of 700 admissions (30·3 per cent). Agreement between the two methods reached 83·3 per cent after verification of ICD-10 codes. The odds ratio for identifying complications using the GTT increased from 5·85 (95 per cent c.i. 4·06 to 8·44) to 25·38 (15·41 to 41·79) when ICD-10 complication codes were verified against patients' medical records.
CONCLUSION
Verified ICD-10 codes strengthen the accuracy of complication rates. Use of non-verified complication codes from administrative systems significantly overestimates in-hospital surgical complication rates.
Identifiants
pubmed: 30229870
doi: 10.1002/bjs.10985
pmc: PMC6519147
doi:
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Pagination
236-244Informations de copyright
© 2018 The Authors. BJS published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.
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