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Identification of prosthetic hip and knee joint infections using administrative databases-A validation study
Christopher E Kandel1, Richard Jenkinson2,3, Jessica Widdifield1,4,5
1Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Infection Control and Hospital Epidemiology
|September 30, 2020
Summary
Combining diagnosis and procedure codes significantly improves the detection of prosthetic joint infections (PJI) in administrative databases. This enhanced method offers better accuracy for identifying PJI cases following hip and knee arthroplasty.
Area of Science:
- Orthopedic Surgery
- Health Informatics
- Epidemiology
Background:
- Prosthetic joint infections (PJI) are serious complications following hip and knee arthroplasty.
- Accurate identification of PJI from administrative databases is crucial for patient care and resource allocation.
Purpose of the Study:
- To evaluate if combining diagnosis and procedure codes improves the detection of PJI in administrative databases.
- To compare the effectiveness of diagnosis codes alone versus combined codes for PJI identification.
Main Methods:
- A validation study was conducted using data from four tertiary-care hospitals in Toronto, Canada (2010-2016).
- Readmissions following primary arthroplasty were analyzed, comparing International Classification of Disease, Tenth Revision (ICD-10) codes against chart review as the reference standard.
- Sensitivity and positive predictive value (PPV) were calculated for different coding combinations.
Main Results:
- A total of 27,802 primary arthroplasties were performed, with 8,844 readmissions analyzed.
- Prosthetic joint infection (PJI) was identified in 6.6% of readmissions.
- Diagnosis codes alone had a sensitivity of 0.88 and PPV of 0.78. Combining PJI diagnosis codes with arthroplasty and peripherally inserted central catheter procedure codes improved sensitivity to 0.92, while PPV remained 0.78.
Conclusions:
- Combinations of diagnosis and procedure codes offer improved detection of prosthetic joint infections (PJI) in administrative databases compared to diagnosis codes alone.
- While combined codes enhance sensitivity, they do not fully capture the specifics of PJI surgical interventions.
