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脑卒中患者的医疗并发症:卒中登记处和医院出院登记处的数据有效性。

Medical complications in patients with stroke: data validity in a stroke registry and a hospital discharge registry.

机构信息

Department of Clinical Epidemiology.

出版信息

Clin Epidemiol. 2010 Aug 9;2:5-13. doi: 10.2147/clep.s8908.

Abstract

BACKGROUND

Stroke patients frequently experience medical complications; yet, data on incidence, causes, and consequences are sparse.

OBJECTIVE

To examine the data validity of medical complications among patients with stroke in a population-based clinical registry and a hospital discharge registry.

METHODS

We examined the predictive values, sensitivity and specificity of medical complications among patients admitted to specialized stroke units and registered in the Danish National Indicator Project (DNIP) and the Danish National Registry of Patients (NRP) between January 2003 and December 2006 (n = 8,024). We retrieved and reviewed medical records from a random sample of patients (n = 589, 7.3%).

RESULTS

We found substantial variation in the data quality of stroke-related medical complication diagnoses both within the specific complications and between the registries. The positive predictive values ranged from 39.0%-87.1% in the DNIP, and from 0.0%-92.9% in the NRP. The negative predictive values ranged from 71.6%-98.9% in the DNIP and from 63.3% to 97.4% in the NRP. In both registries the specificity of the diagnoses was high. The sensitivity ranged from 23.5% (95% confidence interval [CI]: 14.9-35.4) for falls to 62.9% (95% CI: 54.9-70.4) for urinary infection in the DNIP, and from 0.0 (95% CI: 0.0-4.99) for falls to 18.1% (95% CI: 2.3-51.8) for pressure ulcer in the NRP.

CONCLUSION

The DNIP may be useful for studying medical complications among patients with stroke.

摘要

背景

中风患者常发生医疗并发症;然而,关于发病率、病因和后果的数据却很有限。

目的

在基于人群的临床登记处和医院出院登记处中检查中风患者医疗并发症的数据有效性。

方法

我们检查了 2003 年 1 月至 2006 年 12 月期间在丹麦国家指标项目(DNIP)和丹麦国家患者登记处(NRP)中专门收治的中风患者(n=8024)的医疗并发症的预测值、敏感性和特异性。我们从患者中随机抽取了一个样本(n=589,7.3%),检索并审查了病历。

结果

我们发现,DNIP 中特定并发症内和两个登记处之间的中风相关医疗并发症诊断数据质量存在显著差异。阳性预测值范围为 39.0%-87.1%,NRP 为 0.0%-92.9%。阴性预测值范围为 71.6%-98.9%,NRP 为 63.3%-97.4%。在两个登记处中,诊断的特异性都很高。敏感性范围从跌倒的 23.5%(95%置信区间[CI]:14.9-35.4)到尿路感染的 62.9%(95% CI:54.9-70.4),DNIP 中,从跌倒的 0.0(95% CI:0.0-4.99)到压疮的 18.1%(95% CI:2.3-51.8)。

结论

DNIP 可能有助于研究中风患者的医疗并发症。

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