Improving public reporting and data validation for complex surgical site infections after coronary artery bypass graft surgery and hip arthroplasty

Open Forum Infectious Diseases
Michael S CalderwoodSusan S Huang

Abstract

Deep and organ/space surgical site infections (D/OS SSI) cause significant morbidity, mortality, and costs. Rates are publicly reported and increasingly used as quality metrics affecting hospital payment. Lack of standardized surveillance methods threaten the accuracy of reported data and decrease confidence in comparisons based upon these data. We analyzed data from national validation studies that used Medicare claims to trigger chart review for SSI confirmation after coronary artery bypass graft surgery (CABG) and hip arthroplasty. We evaluated code performance (sensitivity and positive predictive value) to select diagnosis codes that best identified D/OS SSI. Codes were analyzed individually and in combination. Analysis included 143 patients with D/OS SSI after CABG and 175 patients with D/OS SSI after hip arthroplasty. For CABG, 9 International Classification of Diseases, 9th Revision (ICD-9) diagnosis codes identified 92% of D/OS SSI, with 1 D/OS SSI identified for every 4 cases with a diagnosis code. For hip arthroplasty, 6 ICD-9 diagnosis codes identified 99% of D/OS SSI, with 1 D/OS SSI identified for every 2 cases with a diagnosis code. This standardized and efficient approach for identifying D/OS SSI can be used by h...Continue Reading

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Citations

Mar 29, 2016·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Alysha RuskElizabeth Henderson
Dec 16, 2016·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Margaret A OlsenVictoria J Fraser
Feb 1, 2017·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Jozica SkufcaOuti Lyytikäinen
Aug 2, 2017·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Michael S CalderwoodLynn Janssen

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Methods Mentioned

BETA
coronary artery bypass
hysterectomy
hip

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