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  1. Trauma registry injury coding is superfluous : A comparison of outcome prediction based on trauma registry international classification of diseases-ninth revision (ICD-9) and hospital information system ICD-9 codes. Discussion.

    Article, Communication - En anglais

    Annual Meeting of the Eastern Association for the Surgery of Trauma. Sanibel (USA), 1997/01/15.

    Background 

    Trauma registries are an essential but expensive tool for monitoring trauma system performance.

    The time required to catalog patients'injuries is the source of much of this expense.

    Typically, 15 minutes of chart review per patient are required, which in a busy trauma center may represent 25% of a full-time employee.

    We hypothesized that International Classification of Disease-Ninth Revision (ICD-9) codes generated by the hospital information system (HI) would be similar to those coded by a dedicated trauma registrar (TR) and would be as accurate as TR ICD-9 codes in predicting outcome.

    Methods 

    One thousand eight hundred twelve patients admitted to a Level I trauma center during 2 years had International Classification of Disease Injury Severity Scores (ICISS) calculated based on HI and TR ICD-9 codes.

    The relative predictive powers of these two ICISSs were then compared for every patient using Receiver Operator Characteristic Curve Area (ROC) and Hosmer Lemeshow Statistics.

    Results 

    Eighty-nine percent of patients (1,608 of 1,812) had identical HI and TR ICISSs.

    Eleven patients'ICISSs differed by>0.1, and only two patients'scores differed by>0.2. ICISS proved to be a powerful predictor of outcome whether derived from HI (ROC=0.884 ; 95% confidence interval (CI)=0.850-0.917) or TR (ROC=0.872 ; 95% Cl=0.837-0.908).

    Although these predictive powers were not significantly different (p=0.076), the trend was for HI to perform better than TR. (...)

    Mots-clés Pascal : Traumatisme, Evaluation, Indice gravité, Relation, Evolution, Intérêt, Codage, Valeur prédictive, Coût, Etude statistique, Homme, Organisation santé, Economie santé

    Mots-clés Pascal anglais : Trauma, Evaluation, Severity score, Relation, Evolution, Interest, Coding, Predictive value, Costs, Statistical study, Human, Public health organization, Health economy

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 97-0484855

    Code Inist : 002B16N. Création : 03/02/1998.