scholarly journals Validation of ICD-9-CM Diagnosis Codes for Surgical Site Infection and Noninfectious Wound Complications After Mastectomy

2016 ◽  
Vol 38 (3) ◽  
pp. 334-339 ◽  
Author(s):  
Margaret A. Olsen ◽  
Kelly E. Ball ◽  
Katelin B. Nickel ◽  
Anna E. Wallace ◽  
Victoria J. Fraser
Keyword(s):  
Surgical Site Infection ◽  
Claims Data ◽  
Wound Complication ◽  
International Classification Of Diseases ◽  
Immediate Breast Reconstruction ◽  
Wound Complications ◽  
Site Infection ◽  
Fat Necrosis ◽  
Tissue Necrosis ◽  
Diagnosis Codes

BACKGROUNDFew studies have validated ICD-9-CM diagnosis codes for surgical site infection (SSI), and none have validated coding for noninfectious wound complications after mastectomy.OBJECTIVESTo determine the accuracy of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes in health insurer claims data to identify SSI and noninfectious wound complications, including hematoma, seroma, fat and tissue necrosis, and dehiscence, after mastectomy.METHODSWe reviewed medical records for 275 randomly selected women who were coded in the claims data for mastectomy with or without immediate breast reconstruction and had an ICD-9-CM diagnosis code for a wound complication within 180 days after surgery. We calculated the positive predictive value (PPV) to evaluate the accuracy of diagnosis codes in identifying specific wound complications and the PPV to determine the accuracy of coding for the breast surgical procedure.RESULTSThe PPV for SSI was 57.5%, or 68.9% if cellulitis-alone was considered an SSI, while the PPV for cellulitis was 82.2%. The PPVs of individual noninfectious wound complications ranged from 47.8% for fat necrosis to 94.9% for seroma and 96.6% for hematoma. The PPVs for mastectomy, implant, and autologous flap reconstruction were uniformly high (97.5%–99.2%).CONCLUSIONSOur results suggest that claims data can be used to compare rates of infectious and noninfectious wound complications after mastectomy across facilities, even though PPVs vary by specific type of postoperative complication. The accuracy of coding was highest for cellulitis, hematoma, and seroma, and a composite group of noninfectious complications (fat necrosis, tissue necrosis, or dehiscence).Infect Control Hosp Epidemiol 2017;38:334–339

scholarly journals Use of Diagnosis Codes and/or Wound Culture Results for Surveillance of Surgical Site Infection after Mastectomy and Breast Reconstruction

2010 ◽  
Vol 31 (05) ◽  
pp. 544-547 ◽  
Author(s):  
Margaret A. Olsen ◽  
Victoria J. Fraser
Keyword(s):  
Surgical Site Infection ◽  
Claims Data ◽  
Breast Surgery ◽  
International Classification Of Diseases ◽  
Site Infection ◽  
Wound Culture ◽  
Diagnosis Codes ◽  
Classification Of Diseases ◽  
Major Breast

We compared surveillance of surgical site infection (SSI) after major breast surgery by using a combination of International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes and microbiology-based surveillance. The sensitivity of the coding algorithm for identification of SSI was 87.5%, and the sensitivity of wound culture for identification of SSI was 78.1%. Our results suggest that SSI surveillance can be reliably performed using claims data.

scholarly journals Incidence of Surgical Site Infection Following Mastectomy With and Without Immediate Reconstruction Using Private Insurer Claims Data

2015 ◽  
Vol 36 (8) ◽  
pp. 907-914 ◽  
Author(s):  
Margaret A. Olsen ◽  
Katelin B. Nickel ◽  
Ida K. Fox ◽  
Julie A. Margenthaler ◽  
Kelly E. Ball ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Claims Data ◽  
Diverse Population ◽  
Site Infection ◽  
Immediate Reconstruction ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Diagnosis Codes ◽  
Unilateral Mastectomy ◽  
Procedure Type

OBJECTIVEThe National Healthcare Safety Network classifies breast operations as clean procedures with an expected 1%–2% surgical site infection (SSI) incidence. We assessed differences in SSI incidence following mastectomy with and without immediate reconstruction in a large, geographically diverse population.DESIGNRetrospective cohort studyPATIENTSCommercially insured women aged 18–64 years with ICD-9-CM procedure or CPT-4 codes for mastectomy from January 1, 2004 through December 31, 2011METHODSIncident SSIs within 180 days after surgery were identified by ICD-9-CM diagnosis codes. The incidences of SSI after mastectomy with and without immediate reconstruction were compared using the χ2 test.RESULTSFrom 2004 to 2011, 18,696 mastectomy procedures among 18,085 women were identified, with immediate reconstruction in 10,836 procedures (58%). The incidence of SSI within 180 days following mastectomy with or without reconstruction was 8.1% (1,520 of 18,696). In total, 49% of SSIs were identified within 30 days post-mastectomy, 24.5% were identified 31–60 days post-mastectomy, 10.5% were identified 61–90 days post-mastectomy, and 15.7% were identified 91–180 days post-mastectomy. The incidences of SSI were 5.0% (395 of 7,860) after mastectomy only, 10.3% (848 of 8,217) after mastectomy plus implant, 10.7% (207 of 1,942) after mastectomy plus flap, and 10.3% (70 of 677) after mastectomy plus flap and implant (P<.001). The SSI risk was higher after bilateral compared with unilateral mastectomy with immediate reconstruction (11.4% vs 9.4%, P=.001) than without (6.1% vs 4.7%, P=.021) immediate reconstruction.CONCLUSIONSSSI incidence was twice that after mastectomy with immediate reconstruction than after mastectomy alone. Only 49% of SSIs were coded within 30 days after operation. Our results suggest that stratification by procedure type facilitates comparison of SSI rates after breast operations between facilities.Infect Control Hosp Epidemiol 2015;36(8):907–914

Changes in the accuracy of administrative data for the detection of surgical site infections

2020 ◽  
pp. 1-3
Author(s):  
Brian T. Bucher ◽  
Meng Yang ◽  
Julie Arndorfer ◽  
Cherie Frame ◽  
Jan Orton ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Retrospective Analysis ◽  
Surgical Site Infections ◽  
International Classification Of Diseases ◽  
Site Infection ◽  
Diagnosis Codes ◽  
Infection Surveillance ◽  
Classification Of Diseases ◽  
Ninth Edition

Abstract We performed a retrospective analysis of the changes in accuracy of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis codes for colectomy and hysterectomy surgical site infection surveillance. After the transition from ICD-CM ninth edition to tenth edition codes, there was no significant change in the accuracy of these codes for SSI surveillance.

scholarly journals 894. Patient and Surgery Characteristics on Wound Complication and Surgical Site Infection in Sarcoma Patients undergoing Hemipelvectomy

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S481-S482
Author(s):  
Ju Hee Katzman ◽  
Steven Sun ◽  
David Joyce ◽  
John Greene
Keyword(s):  
Surgical Site Infection ◽  
Hospital Stay ◽  
Computer Navigation ◽  
Significant Risk ◽  
Wound Complication ◽  
Hospital Length Of Stay ◽  
Categorical Variables ◽  
Wound Complications ◽  
Site Infection ◽  
Increased Risk

Abstract Background Hemipelvectomy is associated with a significant risk of wound complications, including infections, bleeding and injuries to nearby neurovascular structures as well as the gastrointestinal and genitourinary tract. This study aimed to determine the patient characteristics and approach to treatment that could affect the occurrence of surgical site infection or wound complications in sarcoma patients undergone hemipelvectomy. Methods We conducted a retrospective analysis of 33 adult patients who underwent hemipelvectomy at Moffitt Cancer Center, Tampa, FL, from 2008 to 2016. We used Chi-square (Exact Fisher) test to investigate the association between wound complication and categorical variables. We used a T-test to evaluate the difference in numerical variables for outcomes. Results Out of 33 patients, 12 (36.4%) patients experienced wound complications after hemipelvectomy (Table 1). The average age of patients with wound complications was 63.3 3 (57.1±15.4) years old, significantly higher than that of patients without wound complications (p=0.004). Without adjustment, the use of computer navigation had a lower wound complication rate (p=0.027). Patients with wound complications had longer hospital length of stay (14.8 vs. 7.0 days, p=0.016). Among patients with surgical site infection (Table 2), there were no patients’ characteristics or surgical characteristics associated with this outcome. Five (15%) patients developed surgical site infection and they had longer hospital stay (19.4 vs. 8.1 days, p=0.001). The organisms identified from wound cultures include methicillin-resistant Staphylococcus aureus, viridans Streptococcus, Peptostreptococcus asaccharolyticus, Enterobacter cloacae, Pseudomonas aeruginosa, Candida albicans. The organisms in late infections (more than 6 months since surgery), included above organisms plus Stenotrophomonas maltophilia and Achromobacter xylosidans. Conclusion Older patients undergoing hemipelvectomy are at an increased risk of developing wound complications with a prolonged hospital stay. Initial antimicrobial therapy for suspected surgical site infection should include a broad-spectrum coverage to include skin and gastrointestinal flora. Disclosures All Authors: No reported disclosures

Correlation between surgical site infection and obesity after exploratory laparotomy in trauma patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Abdelaziz ◽  
Ahmed Sabry ◽  
Mohamed Fayek
Keyword(s):  
Surgical Site Infection ◽  
Abdominal Trauma ◽  
Damage Control ◽  
Exploratory Laparotomy ◽  
Fascial Closure ◽  
Wound Complications ◽  
Trauma Patients ◽  
Obese Patients ◽  
Site Infection ◽  
University Hospitals

Abstract Background Obesity has become a major contributor to the global burden of chronic disease and disability. Understanding the effect of obesity on the incidence of wound infections and other wound complications remains incomplete despite considerable attention to both the growing ‘‘epidemic’’ of obesity and the frequent occurrence of surgical site infection (SSI) after surgical procedures. Damage-control laparotomy specifically has been associated with a higher rate of infectious complications and a lower rate of primary fascial closure in obese patients. Aim of the work The aim of the study is to evaluate the correlation between obesity and surgical site infection (SSI) in patients undergoing exploratory laparotomy after abdominal trauma. Patients and methods A retrospective study performed on obese patients of both genders aged between 18 and 60 years old undergoing exploratory laparotomy after abdominal trauma at the surgery departments of Ain Shams University Hospitals, Al-Bank Al-Ahly Hospital, Al-Mataria Hospital and Al-Salam Hospital, Cairo, Egypt for two years (1st of January 2018 to 1st of January 2020). Patients with infected wounds, receiving antibiotic therapy at the time of injury, those with a known immunodeficiency, who died within 48 hours after injury, who had sustained burn injuries, who underwent surgery at another institution before admission to our hospital were excluded. The rate of 30-day SSI post-operatively among obese and non-obese patients were compared. Statistical analysis was also done. Results Out of 782 patients, only 480 of those patients for whom BMI data were available, 360 (75%) were males and 120 (25%) were females. Out of the 480 patients: 168 patients had BMI more than 30; 114 patients (67.8%) had SSI (P &lt; 0.05), 312 patients had BMI less than 30; 61 patients (19.5%) had SSI. All of the included patients were fulfilling the inclusion and the exclusion criteria. On multivariate analysis, obesity was the strongest predictor of SSI (odds ratio = 1.59; 95% confidence interval, 1.32-1.91) after adjustment for sex and age. Obese patients with SSI compared with the non-obese had longer hospital stays (mean, 9.5 vs 8.1 days, respectively; P &lt; .001) and markedly higher rates of hospital readmission (27.1% vs 6.5%, respectively; P &lt; .001). Conclusion Obesity is considered as one of the risk factors in causing surgical site infection. Thus, this study showed the relation of BMI and obesity with surgical site infection in case of exploratory laparotomy after abdominal trauma.

The prevalence of localised scleroderma in childhood assessed in the administrative claims data from the United States

2018 ◽  
Vol 4 (1) ◽  
pp. 77-78
Author(s):  
Timothy Beukelman ◽  
Fenglong Xie ◽  
Ivan Foeldvari
Keyword(s):  
United States ◽  
Systemic Sclerosis ◽  
Claims Data ◽  
International Classification Of Diseases ◽  
The United States ◽  
Administrative Claims ◽  
Administrative Claims Data ◽  
Diagnosis Codes ◽  
Classification Of Diseases

Juvenile localised scleroderma is believed an orphan autoimmune disease, which occurs 10 times more often than systemic sclerosis in childhood and is believed to have a prevalence of 1 per 100,000 children. To gain data regarding the prevalence of juvenile localised scleroderma, we assessed the administrative claims data in the United States using the International Classification of Diseases, Ninth Revision diagnosis codes. We found an estimated prevalence in each year ranging from 3.2 to 3.6 per 10,000 children. This estimate is significantly higher as found in previous studies.

Administrative coding methods impact surgical site infection rates

2020 ◽  
Vol 41 (12) ◽  
pp. 1461-1463
Author(s):  
Mohammed A. Alsuhaibani ◽  
Mohammed A. Alzunitan ◽  
Kyle E. Jenn ◽  
Michael B. Edmond ◽  
Angelique M. Dains ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
International Classification Of Diseases ◽  
Site Infection ◽  
Coding System ◽  
Infection Rates ◽  
Coding Method ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
The Impact

AbstractWe performed a retrospective analysis of the impact of using the International Classification of Diseases, Tenth Revision procedure coding system (ICD-10) or current procedural terminology (CPT) codes to calculate surgical site infection (SSI) rates. Denominators and SSI rates vary depending on the coding method used. The coding method used may influence interhospital performance comparisons.

Assessing the prevalence of juvenile systemic sclerosis in childhood using administrative claims data from the United States

2018 ◽  
Vol 3 (2) ◽  
pp. 189-190 ◽  
Author(s):  
Timothy Beukelman ◽  
Fenglong Xie ◽  
Ivan Foeldvari
Keyword(s):  
United States ◽  
Systemic Sclerosis ◽  
Claims Data ◽  
International Classification Of Diseases ◽  
The United States ◽  
Administrative Claims ◽  
Administrative Claims Data ◽  
Diagnosis Codes ◽  
Classification Of Diseases ◽  
Juvenile Systemic Sclerosis

Juvenile systemic sclerosis is a very rare orphan disease. To date, only one publication has estimated the prevalence of juvenile systemic sclerosis using a survey of specialized physicians. We conducted a study of administrative claims data in the United States using the International Classification of Diseases, Ninth Revision diagnosis codes and found a prevalence of approximately 3 per 1,000,000 children. This estimate will inform the planning of prospective studies.

scholarly journals Stratification of Surgical Site Infection by Operative Factors and Comparison of Infection Rates after Hernia Repair

2014 ◽  
Vol 36 (3) ◽  
pp. 329-335 ◽  
Author(s):  
Margaret A. Olsen ◽  
Katelin B. Nickel ◽  
Anna E. Wallace ◽  
Daniel Mines ◽  
Victoria J. Fraser ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Surgical Site Infection ◽  
Ventral Hernia ◽  
Bowel Obstruction ◽  
Ventral Hernia Repair ◽  
International Classification Of Diseases ◽  
Site Infection ◽  
Anatomic Site ◽  
Incisional Ventral Hernia ◽  
Open Versus

ObjectiveTo investigate whether operative factors are associated with risk of surgical site infection (SSI) after hernia repair.DesignRetrospective cohort study.PatientsCommercially insured enrollees aged 6 months-64 years with International Classification of Diseases, Ninth Revision, Clinical Modification procedure or Current Procedural Terminology, fourth edition, codes for inguinal/femoral, umbilical, and incisional/ventral hernia repair procedures from January 1, 2004, through December 31, 2010.MethodsSSIs within 90 days after hernia repair were identified by diagnosis codes. The χ2 and Fisher exact tests were used to compare SSI incidence by operative factors.ResultsA total of 119,973 hernia repair procedures were analyzed. The incidence of SSI differed significantly by anatomic site, with rates of 0.45% (352/77,666) for inguinal/femoral, 1.16% (288/24,917) for umbilical, and 4.11% (715/17,390) for incisional/ventral hernia repair. Within anatomic sites, the incidence of SSI was significantly higher for open versus laparoscopic inguinal/femoral (0.48% [295/61,142] vs 0.34% [57/16,524], P=.020) and incisional/ventral (4.20% [701/16,699] vs 2.03% [14/691], P=.005) hernia repairs. The rate of SSI was higher following procedures with bowel obstruction/necrosis than procedures without obstruction/necrosis for open inguinal/femoral (0.89% [48/5,422] vs 0.44% [247/55,720], P<.001) and umbilical (1.57% [131/8,355] vs 0.95% [157/16,562], P<.001), but not incisional/ventral hernia repair (4.01% [224/5,585] vs 4.16% [491/11,805], P=.645).ConclusionsThe incidence of SSI was highest after open procedures, incisional/ventral repairs, and hernia repairs with bowel obstruction/necrosis. Stratification of hernia repair SSI rates by some operative factors may facilitate accurate comparison of SSI rates between facilities.Infect Control Hosp Epidemiol 2014;00(0): 1–7

scholarly journals The application of close incisional negative pressure wound therapy in revision arthroplasty among asian patients: a comparative study

Arthroplasty ◽  
2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Ping Keung Chan ◽  
Wing Chiu Fung ◽  
Kar Hei Lam ◽  
Winnie Chan ◽  
Vincent Wai Kwan Chan ◽  
...  
Keyword(s):  
Comparative Study ◽  
Surgical Site Infection ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Revision Arthroplasty ◽  
Wound Complications ◽  
Site Infection ◽  
Control Cohort ◽  
Wound Therapy ◽  
Total Knee

Abstract Introduction Peri-prosthetic joint infection (PJI) was one of the main causes of revision of arthroplasty. In order to reduce wound complications and surgical site infections, close incisional negative pressure wound therapy (ciNPWT) has been introduced into arthroplasty. This study was designed to review the clinical benefits of the application of ciNPWT in revision arthroplasty. Methods This was a single-centre retrospective comparative study approved by the Institutional Review Board. Patients, who underwent revision total knee arthroplasty or revision total hip arthroplasty at the author’s institution from January 2016 to October 2019, were included in this study. The ciNPWT cohort included all eligible patients, who underwent operations from January 2018 to October 2019, with the use of ciNPWT(n = 36). The control cohort included all eligible patients, who underwent operations from January 2016 to December 2017 with the use of conventional dressing(n = 48). The incidences of wound complications were compared to both cohorts. Results There was a statistically significant difference in the rate of superficial surgical site infection (SSI) between control cohort and ciNPWT cohort (12.5% in control vs 0% in ciNPWT, p = 0.035). However, there was no statistically significance of the overall wound complication rate for both cohorts. (14.6% in control vs 8.3% in ciNPWT, p = 0.504). Conclusions The application of ciNPWT could result in a lower rate of superficial surgical site infection when compared with conventional dressing among the patients undergoing revision total knee and total hip arthroplasties. Trial registration UW19-706

Sign in / Sign up

Export Citation Format

Share Document