Bodilsen Jacob, Dalager-Pedersen Michael, Kjærgaard Nicolai, van de Beek Diederik, Brouwer Matthijs C, Nielsen Henrik
Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark, c1-clep-10-1503,
Department of Neurology, Amsterdam Neuroscience, Academic Medical Centre, Amsterdam, The Netherlands.
Clin Epidemiol. 2018 Oct 12;10:1503-1508. doi: 10.2147/CLEP.S176072. eCollection 2018.
To evaluate the positive predictive value (PPV) of ICD-10 diagnosis codes for brain abscess in the Danish National Patient Registry (DNPR).
We examined medical records of all patients with a first-time diagnosis code of brain abscess in the DNPR from 2007 to 2016. Patients were categorized with either confirmed or disproved brain abscess using a priori defined criteria. We computed the PPV as the proportion of confirmed diagnoses.
We identified 709 patients, of whom the medical records could not be retrieved for 15 patients, leaving 694 for further analyses. Of these, 444 had a confirmed brain abscess and 250 had another proven diagnosis, including 47 cases of intracranial empyema. The overall PPV was 64% (95% CI: 60-68) ranging from 24% to 96% among the different codes evaluated. By including only patients with either 1) both a diagnosis and surgical procedure code for brain abscess or 2) patients admitted to hospital with certain primary diagnosis codes (DG060[C,E,F] or DG079B) without newly diagnosed central nervous system (CNS) cancer, spondylodiscitis/intraspinal abscess, or procedure codes for evacuation of intracranial empyema, the PPV increased to 84% (95% CI 80-87) and 89% (395/444) of all confirmed cases were identified.
The overall PPV of diagnosis codes for brain abscess in the DNPR was moderate. However, by exclusion of newly diagnosed CNS tumors, spondylodiscitis/intraspinal abscess, and intracranial empyemas, the PPV was high and therefore suitable for future registry-based studies of brain abscess.
评估丹麦国家患者登记处（DNPR）中脑脓肿的国际疾病分类第十版（ICD - 10）诊断编码的阳性预测值（PPV）。
我们检查了2007年至2016年期间在DNPR首次诊断为脑脓肿的所有患者的病历。根据预先定义的标准，将患者分为脑脓肿确诊或排除的类别。我们将PPV计算为确诊诊断的比例。
我们确定了709例患者，其中15例患者的病历无法检索到，剩下694例进行进一步分析。在这些患者中，444例确诊为脑脓肿，250例有其他已证实的诊断，包括47例颅内积脓。总体PPV为64%（95%可信区间：60 - 68），在所评估的不同编码中，PPV范围为24%至96%。通过仅纳入以下患者：1）既有脑脓肿诊断编码又有手术操作编码的患者；或2）因某些原发性诊断编码（DG060[C、E、F]或DG079B）入院且无新诊断的中枢神经系统（CNS）癌症、脊椎间盘炎/脊髓内脓肿或颅内积脓引流手术操作编码的患者，PPV增至84%（95%可信区间80 - 87），并且在所有确诊病例中，89%（395/444）的病例被识别出来。
DNPR中脑脓肿诊断编码的总体PPV中等。然而，通过排除新诊断的CNS肿瘤、脊椎间盘炎/脊髓内脓肿和颅内积脓，PPV较高，因此适用于未来基于登记处的脑脓肿研究。
