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Measuring adverse events following hip arthroplasty surgery using administrative data without relying on ICD-codes

Magneli, Martin ; Unbeck, Maria ; Rogmark, Cecilia LU ; Skoldenberg, Olof and Gordon, Max (2020) In PLoS ONE 15(11 November).
Abstract

Introduction Measure and monitor adverse events (AEs) following hip arthroplasty is challenging. The aim of this study was to create a model for measuring AEs after hip arthroplasty using administrative data, such as length of stay and readmissions, with equal or better precision than an ICD-code based model. Materials and methods This study included 1 998 patients operated with an acute or elective hip arthroplasty in a national multi-centre study. We collected AEs within 90 days following surgery with retrospective record review. Additional data came from the Swedish Hip Arthroplasty Register, the Swedish National Patient Register and the Swedish National Board of Health and Welfare. We made a 2:1 split of the data into a training and... (More)

Introduction Measure and monitor adverse events (AEs) following hip arthroplasty is challenging. The aim of this study was to create a model for measuring AEs after hip arthroplasty using administrative data, such as length of stay and readmissions, with equal or better precision than an ICD-code based model. Materials and methods This study included 1 998 patients operated with an acute or elective hip arthroplasty in a national multi-centre study. We collected AEs within 90 days following surgery with retrospective record review. Additional data came from the Swedish Hip Arthroplasty Register, the Swedish National Patient Register and the Swedish National Board of Health and Welfare. We made a 2:1 split of the data into a training and a holdout set. We used the training set to train different machine learning models to predict if a patient had sustained an AE or not. After training and cross-validation we tested the best performing model on the holdoutset. We compared the results with an established ICD-code based measure for AEs. Results The best performing model was a logistic regression model with four natural age splines. The variables included in the model were as follows: Length of stay at the orthopaedic department, discharge to acute care, age, number of readmissions and ED visits. The sensitivity and specificity for the new model was 23 and 90% for AE within 30 days, compared with 5 and 94% for the ICD-code based model. For AEs within 90 days the sensitivity and specificity were 31% and 89% compared with 16% and 92% for the ICD-code based model. Conclusion We conclude that a prediction model for AEs following hip arthroplasty surgery, relying on administrative data without ICD-codes is more accurate than a model based on ICD-codes.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
PLoS ONE
volume
15
issue
11 November
article number
e0242008
publisher
Public Library of Science (PLoS)
external identifiers
  • scopus:85095771682
  • pmid:33152055
ISSN
1932-6203
DOI
10.1371/journal.pone.0242008
language
English
LU publication?
yes
id
24b28e7a-1b8d-4fc9-90b6-3cdb1364ce7f
date added to LUP
2020-11-26 15:59:00
date last changed
2024-07-25 05:22:22
@article{24b28e7a-1b8d-4fc9-90b6-3cdb1364ce7f,
  abstract     = {{<p>Introduction Measure and monitor adverse events (AEs) following hip arthroplasty is challenging. The aim of this study was to create a model for measuring AEs after hip arthroplasty using administrative data, such as length of stay and readmissions, with equal or better precision than an ICD-code based model. Materials and methods This study included 1 998 patients operated with an acute or elective hip arthroplasty in a national multi-centre study. We collected AEs within 90 days following surgery with retrospective record review. Additional data came from the Swedish Hip Arthroplasty Register, the Swedish National Patient Register and the Swedish National Board of Health and Welfare. We made a 2:1 split of the data into a training and a holdout set. We used the training set to train different machine learning models to predict if a patient had sustained an AE or not. After training and cross-validation we tested the best performing model on the holdoutset. We compared the results with an established ICD-code based measure for AEs. Results The best performing model was a logistic regression model with four natural age splines. The variables included in the model were as follows: Length of stay at the orthopaedic department, discharge to acute care, age, number of readmissions and ED visits. The sensitivity and specificity for the new model was 23 and 90% for AE within 30 days, compared with 5 and 94% for the ICD-code based model. For AEs within 90 days the sensitivity and specificity were 31% and 89% compared with 16% and 92% for the ICD-code based model. Conclusion We conclude that a prediction model for AEs following hip arthroplasty surgery, relying on administrative data without ICD-codes is more accurate than a model based on ICD-codes.</p>}},
  author       = {{Magneli, Martin and Unbeck, Maria and Rogmark, Cecilia and Skoldenberg, Olof and Gordon, Max}},
  issn         = {{1932-6203}},
  language     = {{eng}},
  number       = {{11 November}},
  publisher    = {{Public Library of Science (PLoS)}},
  series       = {{PLoS ONE}},
  title        = {{Measuring adverse events following hip arthroplasty surgery using administrative data without relying on ICD-codes}},
  url          = {{http://dx.doi.org/10.1371/journal.pone.0242008}},
  doi          = {{10.1371/journal.pone.0242008}},
  volume       = {{15}},
  year         = {{2020}},
}