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Accuracy of surgical complication rate estimation using ICD-10 codes.

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Summary
This summary is machine-generated.

Verified ICD-10 codes accurately identify surgical complications. Using unverified codes overestimates complication rates, highlighting the need for verification in patient safety and healthcare policy.

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Area of Science:

  • Medical Informatics
  • Health Services Research
  • Surgical Quality Improvement

Background:

  • International Classification of Diseases, 10th Revision (ICD-10) codes are crucial for global health data comparison, patient safety, and policy development.
  • Accurate identification of surgical complications is essential for improving patient outcomes and healthcare efficiency.
  • The Global Trigger Tool (GTT) methodology is an established standard for identifying patient complications.

Purpose of the Study:

  • To investigate the accuracy of surgical complication rates identified by ICD-10 codes.
  • To validate ICD-10 code-based complication estimates against the established Global Trigger Tool (GTT) methodology.

Main Methods:

  • A prospective observational study involving 700 surgical admissions across two Norwegian hospitals.
  • Complications were identified and classified by expert GTT teams reviewing medical records.
  • Three reviewers verified ICD-10 codes for complications against patient medical records.

Main Results:

  • Initial ICD-10 coding identified 519 possible complications in 332 admissions (47.4%).
  • Verification confirmed 298 in-hospital complications in 141 admissions (20.1%) using ICD-10 codes.
  • The GTT methodology identified 331 complications in 212 admissions (30.3%).
  • Agreement between verified ICD-10 codes and GTT was 83.3%; verified codes significantly increased the odds of identifying complications.

Conclusions:

  • Verified ICD-10 codes enhance the accuracy of surgical complication rates.
  • Unverified ICD-10 codes from administrative data significantly overestimate in-hospital surgical complication rates.
  • Accurate coding and verification are vital for reliable patient safety metrics and healthcare economic evaluations.