验证ICD-10代码用于研究异物气道阻塞:健康行政数据队列研究
Cody L Dunne1,2, Julia Cirone1, Andrew D McRae1,2
1Department of Emergency Medicine, University of Calgary, Calgary, AB, Canada.
Resuscitation plus
|October 16, 2023
概括
这项研究验证了国际疾病分类第10版 (ICD-10) 代码,用于在健康数据库中识别异物气道阻塞 (FBAO). 虽然特定的ICD-10代码组合显示出希望,但一些FBAO病例仍未被发现,突出了伤害报告中的关键差距.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 医疗信息学 医疗信息学
背景情况:
- 外体气道阻塞 (FBAO) 是造成伤害的一个重要原因.
- 在行政卫生数据库中准确识别FBAO病例对于改善伤害监测和报告至关重要.
- 在健康记录中识别FBAO的现有方法可能缺乏精度.
研究的目的:
- 为了验证FBAO的病例定义,使用国际疾病分类第10版 (ICD-10) 代码.
- 评估ICD-10代码在管理卫生数据库内识别FBAO患者时的准确性.
- 改进报告FBAO受伤的情况.
主要方法:
- 使用了加拿大阿尔伯塔省 (2018-2021) 的医院前患者护理记录.
- 链接紧急医疗服务 (EMS) 与医院行政数据的遭遇,包括ICD-10代码.
- 雇佣独立的医生审查以确认真实的FBAO病例,并计算了各种ICD-10代码算法的诊断准确度.
主要成果:
- 确定了3677次EMS遭遇,其中2121次与医院数据相关;38.9%的人被证实FBAO.
- 一种ICD-10代码T17和T18.0的组合显示出高特异性 (96.9%).
- 最敏感的算法 (75.0%) 包括所有与FBAO相关的ICD-10代码加R06.8.8. 另外还发现了453例不通过EMS运输的FBAO病例,其中9.7%导致死亡.
结论:
- ICD-10代码可以在卫生行政数据中以合理的准确度识别FBAO.
- 使用ICD-10代码的算法在敏感性和特异性之间进行了权衡.
- 这些算法错过了大量的FBAO病例,包括致命病例,这表明需要改进识别策略.
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