[严重急性呼吸道感染病例定义的有效性基于四个自治区的ICD-10代码 (西班牙,2021-2023) ]
Marcos Lozano Álvarez1,2,3, Alba Moya Garcés4, Liher Imaz Goienetxea5
1Centro Nacional de Epidemiología. Instituto de Salud Carlos III. Madrid. España.
Revista espanola de salud publica
|June 12, 2025
概括
ICD-10代码有效地识别了因流感和SARS-CoV-2而住院的情况. 然而,它们对呼吸道同胞病毒 (RSV) 监测的准确性不那么可靠,并且因年龄组而异.
科学领域:
- 流行病学 流行病学
- 传染性疾病 传染性疾病
- 医疗信息学 医疗信息学
背景情况:
- 通过使用诊断代码,可以加强严重急性呼吸道感染 (SARI) 的自动监测.
- 国际疾病分类第10版 (ICD-10) 代码在医疗机构中广泛使用.
- 对特定病原体验证这些代码对于公共卫生监测至关重要.
研究的目的:
- 评估基于ICD-10的病例定义 (CDs) 对严重急性呼吸道感染 (SARI) 监测的有效性.
- 为了比较不同ICD-10代码组合的性能,用于识别流感,SARS-CoV-2和RSV住院.
- 确定基于ICD-10的最佳CD,平衡关键呼吸道病原体的敏感性和特异性.
主要方法:
- 分析医院出院数据与呼吸道ICD-10代码 (J00-J99,R06,U07) 和实验室测试从2021-2023.
- 评估所有可能的ICD-10代码组合用于SARI案例定义.
- 根据平均敏感性 (Se) 和特异性 (Sp) 优先考虑病例定义,并根据病原体和年龄组进行专家审查以进行优化.
主要成果:
- 对于流感 (Se=95.4%,Sp=99.7%) 和SARS-CoV-2 (Se=95.9%,Sp=98.3%) 已经确定了非常有效的ICD-10CD.
- 使用ICD-10代码的RSV监测显示出较低的有效性 (Se=63.9%,Sp=88.4%),与年龄相关的显著变化.
- 一个针对RSV的优化CD,包括成年人的J98,提高了灵敏度 (Se=88.9%),但降低了特异性 (Sp=65.3%).
结论:
- ICD-10代码对于检测流感和SARS-CoV-2住院的情况非常有效.
- 针对RSV监测的ICD-10代码的性能不足于最佳,需要仔细考虑特定年龄的变化.
- 根据ICD-10改进的病例定义可以支持对呼吸道感染的公共卫生监测工作.
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