手术程序协调编码系统及五个欧洲国家手术部位感染（SSI）分析。

Harmonized procedure coding system for surgical procedures and analysis of surgical site infections (SSI) of five European countries.

机构信息

Department I for Internal Medicine, Excellence Centre for Medical Mycology (ECMM), University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany.

Cologne Cluster of Excellence in Cellular Stress Responses in Aging-Associated Disease (CECAD), University of Cologne, Cologne, Germany.

出版信息

BMC Med Res Methodol. 2022 Aug 12;22(1):225. doi: 10.1186/s12874-022-01702-w.

DOI:10.1186/s12874-022-01702-w

PMID:35962320

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9374282/

Abstract

BACKGROUND

The use of routine data will be essential in future healthcare research. Therefore, harmonizing procedure codes is a first step to facilitate this approach as international research endeavour. An example for the use of routine data on a large scope is the investigation of surgical site infections (SSI). Ongoing surveillance programs evaluate the incidence of SSI on a national or regional basis in a limited number of procedures. For example, analyses by the European Centre for Disease Prevention (ECDC) nine procedures and provides a mapping table for two coding systems (ICD9, National Healthcare Safety Network [NHSN]). However, indicator procedures do not reliably depict overall SSI epidemiology. Thus, a broader analysis of all surgical procedures is desirable. The need for manual translation of country specific procedures codes, however, impedes the use of routine data for such an analysis on an international level. This project aimed to create an international surgical procedure coding systems allowing for automatic translation and categorization of procedures documented in country-specific codes.

METHODS

We included the existing surgical procedure coding systems of five European countries (France, Germany, Italy, Spain, and the United Kingdom [UK]). In an iterative process, country specific codes were grouped in ever more categories until each group represented a coherent unit based on method of surgery, interventions performed, extent and site of the surgical procedure. Next two ID specialist (arbitrated by a third in case of disagreement) independently assigned country-specific codes to the resulting categories. Finally, specialist from each surgical discipline reviewed these assignments for their respective field.

RESULTS

A total number of 153 SALT (Staphylococcus aureus Surgical Site Infection Multinational Epidemiology in Europe) codes from 10 specialties were assigned to 15,432 surgical procedures. Almost 4000 (26%) procedure codes from the SALT coding system were classified as orthopaedic and trauma surgeries, thus this medical field represents the most diverse group within the SALT coding system, followed by abdominal surgical procedures with 2390 (15%) procedure codes.

CONCLUSION

Mapping country-specific codes procedure codes onto to a limited number of coherent, internally and externally validated codes proofed feasible. The resultant SALT procedure code gives the opportunity to harmonize big data sets containing surgical procedures from international centres, and may simplify comparability of future international trial findings.

TRIAL REGISTRATION

The study was registered at clinicaltrials.gov under NCT03353532 on November 27, 2017.

摘要

背景

在未来的医疗保健研究中，常规数据的使用将是至关重要的。因此，协调程序代码是促进这一国际研究努力的第一步。一个使用常规数据的大型示例是调查手术部位感染 (SSI)。正在进行的监测计划在有限数量的程序中按国家或地区评估 SSI 的发生率。例如，欧洲疾病预防控制中心 (ECDC) 的分析涵盖了 9 种程序，并提供了两个编码系统（ICD9、国家医疗保健安全网络 [NHSN]）的映射表。然而，指标程序并不能可靠地描述总体 SSI 流行病学。因此，需要对所有手术程序进行更广泛的分析。然而，由于需要手动翻译特定国家的程序代码，因此妨碍了在国际层面上使用常规数据进行此类分析。本项目旨在创建一个国际手术程序编码系统，允许自动翻译和分类在特定国家/地区编码中记录的程序。

方法

我们纳入了五个欧洲国家（法国、德国、意大利、西班牙和英国）现有的手术程序编码系统。在一个迭代过程中，将特定国家的代码分组到越来越多的类别中，直到每个组都基于手术方法、进行的干预、手术的范围和部位代表一个连贯的单元。接下来，两名 ID 专家（如有分歧，由第三名仲裁）将特定国家的代码独立分配给产生的类别。最后，来自每个外科专业的专家审查了这些分配，以了解他们各自的领域。

结果

从 10 个专业中分配了 153 个 SALT（金黄色葡萄球菌手术部位感染的多国欧洲流行病学）代码到 15322 个手术程序。来自 SALT 编码系统的近 4000 个（26%）程序代码被归类为矫形和创伤手术，因此该医疗领域是 SALT 编码系统中最多样化的组，其次是腹部手术程序，有 2390 个（15%）程序代码。