丹麦国家患者登记处 ICD-10 医院诊断脓胸的阳性预测值。
Positive predictive value of the ICD-10 hospital diagnosis of pleural empyema in the Danish National Registry of Patients.
机构信息
Department of Clinical Microbiology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark;
出版信息
Clin Epidemiol. 2011 Feb 23;3:85-9. doi: 10.2147/CLEP.S16931.
OBJECTIVE
Health care databases are a valuable source for epidemiological research in respiratory diseases if diagnoses are valid. We validated the International Classification of Diseases, 10th revision (ICD-10) diagnosis of pleural empyema in the Danish National Registry of Patients (DNRP).
METHODS
We randomly selected hospitalized patients registered in the DNRP with a discharge diagnosis of pleural empyema between 1995 and 2009 in the North Denmark Region. We retrieved and reviewed medical records and estimated the positive predictive value (PPV) of the empyema diagnosis. Analyses were stratified by study period, hospital type (referral versus district), department type (pulmonary medicine or thoracic surgery versus other), cause of empyema (medical, surgical, or traumatic), and age group. To assess changes over time, we included chi-square tests for linear trend.
RESULTS
We retrieved the medical records of 224/225 sampled patients with empyema (99.6%). Of those, 182 were classified as being definite cases, and 21 were probable cases, yielding a PPV of 90.6% (95% confidence interval [CI]: 86.0-94.1). The PPV decreased from 95.7% in patients aged 15-39 years to 87.5% in patients aged 80 years and over but was uniformly high regardless of study period, hospital or department type, or cause of empyema.
CONCLUSION
Our finding of a high overall PPV indicated good agreement between ICD-10 codes for pleural empyema and medical records. Registry-based discharge codes may be a suitable source of data on pleural empyema for epidemiological research.
目的
如果诊断有效，医疗保健数据库是呼吸系统疾病流行病学研究的宝贵资源。我们验证了丹麦患者登记处（DNRP）中第 10 次国际疾病分类（ICD-10）胸腔积脓的诊断。
方法
我们随机选择了 1995 年至 2009 年在丹麦北地区登记的 DNRP 中以胸腔积脓为出院诊断的住院患者。我们检索并审查了病历，并估计了积脓诊断的阳性预测值（PPV）。分析按研究期间、医院类型（转诊与地区）、科室类型（呼吸科或胸外科与其他）、积脓原因（内科、外科或创伤）和年龄组分层。为了评估随时间的变化，我们纳入了线性趋势的卡方检验。
结果
我们检索了 225 名积脓抽样患者中的 224 名患者的病历（99.6%）。其中，182 例被归类为明确病例，21 例为可能病例，阳性预测值为 90.6%（95%置信区间[CI]：86.0-94.1）。PPV 从 15-39 岁患者的 95.7%降至 80 岁及以上患者的 87.5%，但无论研究期间、医院或科室类型、或积脓原因如何，PPV 均保持较高水平。
结论
我们发现总体 PPV 较高，表明 ICD-10 胸腔积脓代码与病历之间具有良好的一致性。基于登记的出院代码可能是胸腔积脓流行病学研究的合适数据来源。
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