Acute Care Surgery Service, Department of General Surgery, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157, USA.
J Am Coll Surg. 2012 Feb;214(2):156-63. doi: 10.1016/j.jamcollsurg.2011.11.001. Epub 2011 Dec 6.
As emergency general surgery (EGS) evolves, an EGS patient-tracking database (EGS registry [EGSR]) similar to the National Trauma Data Bank (NTDB) will be essential to study outcomes and improve care. The goal of this study was to establish diagnostic ICD-9 codes to define EGS patients. The hypothesis was that creating standardized ICD-9-based inclusion criteria would facilitate patient identification for an EGSR and aid in its ongoing development.
We conducted a retrospective review of EGS admissions over a 9-month period to define ICD-9 diagnostic codes of patients admitted to our EGS service. Subsequently, prospective data were collected into the EGSR by testing ICD-9-based inclusion criteria over 1 month. Patient, hospital, and severity scoring variables, as well as quality assurance information, were identified.
We identified 959 admissions to the EGS service over 9 months with 306 ICD-9 diagnosis codes that define EGS patients; the prospective population of the EGSR confirmed feasibility of ICD-9-based inclusion criteria. The EGSR captures 107 data points and 33 comorbidities per patient over 11 categories, akin to the 10 NTDB categories.
Following the model of the NTDB, we have successfully completed creation and initial implementation of an EGSR by using ICD-9-based inclusion criteria. Our comprehensive EGSR creates a prospective data-collection modality to capture and define EGS patients. A uniform patient-tracking EGSR, akin to the NTDB, will advance the science of acute care surgery, improve EGS patient outcomes, and facilitate multi-institutional collaboration.
随着急诊普通外科（EGS）的发展，类似于国家创伤数据库（NTDB）的 EGS 患者跟踪数据库（EGSR）对于研究结果和改善护理至关重要。本研究的目的是建立诊断 ICD-9 代码来定义 EGS 患者。假设创建基于标准化 ICD-9 的纳入标准将有助于识别 EGSR 患者并促进其持续发展。
我们对 9 个月内 EGS 入院患者进行了回顾性审查，以确定我们 EGS 服务收治的患者的 ICD-9 诊断代码。随后，通过在 1 个月内测试基于 ICD-9 的纳入标准，前瞻性地收集 EGSR 数据。确定了患者、医院和严重程度评分变量以及质量保证信息。
我们在 9 个月内发现 959 例 EGS 服务入院患者，有 306 个 ICD-9 诊断代码定义 EGS 患者；EGSR 的前瞻性人群证实了基于 ICD-9 的纳入标准的可行性。EGSR 在 11 个类别中捕获每个患者的 107 个数据点和 33 种合并症，类似于 NTDB 的 10 个类别。
在 NTDB 的模式下，我们成功地使用基于 ICD-9 的纳入标准创建和初步实施了 EGSR。我们全面的 EGSR 创建了一种前瞻性的数据收集模式，以捕获和定义 EGS 患者。类似于 NTDB 的统一患者跟踪 EGSR 将推进急性护理外科学的科学研究，改善 EGS 患者的结果，并促进多机构合作。
