scholarly journals Can Additional Information Be Obtained from Claims Data to Support Surgical Site Infection Diagnosis Codes?

2014 ◽  
Vol 35 (S3) ◽  
pp. S124-S132 ◽  
Author(s):  
David K. Warren ◽  
Katelin B. Nickel ◽  
Anna E. Wallace ◽  
Daniel Mines ◽  
Victoria J. Fraser ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Acl Reconstruction ◽  
Claims Data ◽  
Cruciate Ligament ◽  
Surgical Site Infections ◽  
International Classification Of Diseases ◽  
Additional Information ◽  
Diagnosis Codes ◽  
Classification Of Diseases ◽  
Anterior Cruciate

Objective.International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes are increasingly used to identify healthcare-associated infections, often with insufficient evidence demonstrating validity of the codes used. Absent medical record verification, we sought to confirm a claims algorithm to identify surgical site infections (SSIs) by examining the presence of clinically expected SSI treatment.Methods.We performed a retrospective cohort study, using private insurer claims data from persons less than 65 years old with ICD-9-CM procedure or Current Procedure Terminology (CPT-4) codes for anterior cruciate ligament (ACL) reconstruction from January 2004 through December 2010. SSIs occurring within 90 days after ACL reconstruction were identified by ICD-9-CM diagnosis codes. Antibiotic utilization, surgical treatment, and microbiology culture claims within 14 days of SSI codes were used as evidence to support the SSI diagnosis.Results.Of 40,702 procedures, 401 (1.0%) were complicated by SSI, 172 (0.4%) of which were specifically identified as septic arthritis. Most SSIs were associated with an inpatient admission (232/401 [58%]), and/or surgical procedure(s) for treatment (250/401 [62%]). Temporally associated antibiotics, surgical treatment procedures, and cultures were present for 84% (338/401), 61% (246/401), and 59% (238/401), respectively. Only 5.7% (23/401) of procedures coded for SSI after the procedure had no antibiotics, surgical treatments, or cultures within 14 days of the SSI claims.Conclusions.More than 94% of patients identified by our claims algorithm as having an SSI received clinically expected treatment for infection, including antibiotics, surgical treatment, and culture, suggesting that this algorithm has very good positive predictive value. This method may facilitate retrospective SSI surveillance and comparison of SSI rates across facilities and providers.

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.

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.

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 Meniscal Tearing after ACL Reconstruction

2000 ◽  
Vol 8 (1) ◽  
pp. 53-59 ◽  
Author(s):  
S Ichinohe ◽  
M Yoshida ◽  
H Murakami ◽  
H Takayama ◽  
S Izumiyama ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Acl Reconstruction ◽  
Pivot Shift ◽  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Meniscal Tears ◽  
Progressive Change ◽  
Secondary Osteoarthritis ◽  
Anterior Cruciate

The knees of 72 patients with unilateral anterior-cruciate-ligament (ACL) injury were analyzed before ACL reconstruction as well as by follow-up arthroscopy on the day of staple removal. At ACL reconstruction 31 lateral menisci and 40 medial menisci were found to be normal. 28 lateral menisci and 24 medial menisci were treated surgically, while 13 lateral menisci and 8 medial menisci with small or incomplete meniscal tearing were not treated. At follow-up arthroscopy there were 3 new cases of lateral meniscal tearing and 3 new cases of medial meniscal tearing in the groups diagnosed as normal prior to surgery. Two of the 13 cases with small or incomplete lateral meniscal tearing required resection, 8 healed and the other 3 demonstrated no progressive change. Four of the 8 cases with small or incomplete medial meniscal tears healed, 3 exhibited no progressive change and one required surgical treatment. There was no correlation between meniscal tearing and knee instability as indicated by a positive Lachman test or a positive pivot shift sign. The results of the present study indicate that ACL reconstruction prevents progressive changes in meniscal tears and will prevent secondary osteoarthritis, and that some small tears of the lateral meniscus require no surgical treatment.

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.

The Utility of Claims Data for Infection Surveillance following Anterior Cruciate Ligament Reconstruction

2014 ◽  
Vol 35 (6) ◽  
pp. 652-659 ◽  
Author(s):  
Michael V. Murphy ◽  
Dongyi (Tony) Du ◽  
Wei Hua ◽  
Karoll J. Cortez ◽  
Melissa G. Butler ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Chart Review ◽  
Claims Data ◽  
Cruciate Ligament ◽  
Deep Infection ◽  
Emergency Department Visits ◽  
Infection Surveillance ◽  
Anterior Cruciate ◽  
Procedure Codes

Objective.To explore the feasibility of identifying anterior cruciate ligament (ACL) allograft implantations and infections using claims.Design.Retrospective cohort study.Methods.We identified ACL reconstructions using procedure codes at 6 health plans from 2000 to 2008. We then identified potential infections using claims-based indicators of infection, including diagnoses, procedures, antibiotic dispensings, specialty consultations, emergency department visits, and hospitalizations. Patients’ medical records were reviewed to determine graft type, validate infection status, and calculate sensitivity and positive predictive value (PPV) for indicators of ACL allografts and infections.Results.A total of 11,778 patients with codes for ACL reconstruction were identified. After chart review, PPV for ACL reconstruction was 96% (95% confidence interval [CI], 94%–97%). Of the confirmed ACL reconstructions, 39% (95% CI, 35%–42%) used allograft tissues. The deep infection rate after ACL reconstruction was 1.0% (95% CI, 0.7%–1.4%). The odds ratio of infection for allografts versus autografts was 0.41 (95% CI, 0.19–0.78). Sensitivity of individual claims-based indicators for deep infection after ACL reconstruction ranged from 0% to 75% and PPV from 0% to 100%. Claims-based infection indicators could be combined to enhance sensitivity or PPV but not both.Conclusions.While claims data accurately identify ACL reconstructions, they poorly distinguish between allografts and autografts and identify infections with variable accuracy. Claims data could be useful to monitor infection trends after ACL reconstruction, with different algorithms optimized for different surveillance goals.Infect Control Hosp Epidemiol 2014;35(6):652–659

scholarly journals Bridge-Enhanced Anterior Cruciate Ligament Repair Leads to Greater Limb Asymmetry and Less Cartilage Damage Than Untreated ACL Transection or ACL Reconstruction in the Porcine Model

2021 ◽  
Vol 49 (3) ◽  
pp. 667-674
Author(s):  
Naga Padmini Karamchedu ◽  
Martha M. Murray ◽  
Jakob T. Sieker ◽  
Benedikt L. Proffen ◽  
Gabriela Portilla ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Surgical Treatment ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Cartilage Damage ◽  
Maximum Force ◽  
Impulse Loading ◽  
Acl Repair ◽  
Anterior Cruciate ◽  
Acl Transection

Background: The extent of posttraumatic osteoarthritis (PTOA) in the porcine anterior cruciate ligament (ACL) transection model is dependent on the surgical treatment selected. In a previous study, animals treated with bridge-enhanced ACL repair using a tissue-engineered implant developed less PTOA than those treated with ACL reconstruction (ACLR). Alterations in gait, including asymmetric weightbearing and shorter stance times, have been noted in clinical studies of subjects with osteoarthritis. Hypothesis: Animals receiving a surgical treatment that results in less PTOA (ie, bridge-enhanced ACL repair) would exhibit fewer longitudinal postoperative gait asymmetries over a 1-year period when compared with treatments that result in greater PTOA (ie, ACLR and ACL transection). Study Design: Controlled laboratory study. Methods: Thirty-six Yucatan minipigs underwent ACL transection and were randomized to receive (1) no further treatment, (2) ACLR, or (3) bridge-enhanced ACL repair. Gait analyses were performed preoperatively, and at 4, 12, 26, and 52 weeks postoperatively. Macroscopic cartilage assessments were performed at 52 weeks. Results: Knees treated with bridge-enhanced ACL repair had less macroscopic damage in the medial tibial plateau than those treated with ACLR or ACL transection (adjusted P = .03 for both comparisons). The knees treated with bridge-enhanced ACL repair had greater asymmetry in hindlimb maximum force and impulse loading at 52 weeks than the knees treated with ACL transection (adjusted P < .05 for both comparisons). Although not significant, there was a trend that knees treated with bridge-enhanced ACL repair had greater asymmetry in hindlimb maximum force and impulse loading (adjusted P < .10 for both comparisons) compared with ACLR. Conclusion: Contrary to our hypothesis, the surgical treatment resulting in less macroscopic cartilage damage (ie, bridge-enhanced ACL repair) exhibited greater asymmetry in load-related gait parameters than the other surgical groups. This finding suggests that increased offloading of the surgical knee may be associated with a slower rate of PTOA development. Clinical Relevance: Less cartilage damage at 52 weeks was found in the surgical group that continued to protect the limb from full body weight during gait. This finding suggests that protection of the knee from maximum stresses may be important in minimizing the development of PTOA in the ACL-injured knee within 1 year.

scholarly journals GRAFT LIGAMENTIZATION OF ANTERIOR CRUCIATE LIGAMENT

2016 ◽  
Vol 7 (3) ◽  
pp. 3-7
Author(s):  
A A Akhpashev ◽  
E A Dzhambinova ◽  
E A Zvezdkina ◽  
A S Kanaev ◽  
A N Tkalin
Keyword(s):  
Anterior Cruciate Ligament ◽  
Surgical Treatment ◽  
Knee Joint ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Mr Studies ◽  
Treatment Results ◽  
Anterior Cruciate

The article presents an analysis of surgical treatment results of 71 patients, operated on for rupture of the anterior cruciate ligament (ACL) in the department of traumatology and orthopedics FSСС FMBA of Russia in 2013-2016. All patients underwent primary arthroscopic ACL reconstruction with autograft from tendons gracilis and semitendinosus. We assessed the condition of the operated knee joint on MRI after 3 - 6 - 12 - 24 months after surgery. Based on the criteria of MR studies, we concluded that the non-uniform diffuse change of MR signal from the graft on T2, PD FS can be traced in the first 2 years after surgery, reflecting process of ligamentization. In the first three months we also observed an increase in the diameter of the graft, which further regressed. Process of ligamentization ends within two years after the operation, whereby the signal from the MR-graft should be similar to the native ACL.

Subsequent Surgery for Loss of Motion After Anterior Cruciate Ligament Reconstruction Does Not Influence Function at 2 Years: A Matched Case-Control Analysis

2019 ◽  
Vol 47 (11) ◽  
pp. 2550-2556 ◽  
Author(s):  
Jacob Worsham ◽  
Walter R. Lowe ◽  
Dorcas Copa ◽  
Shelby Williams ◽  
Jacquelyn Kleihege ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Surgical Treatment ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Knee Function ◽  
Quality Data ◽  
Control Group ◽  
Manipulation Under Anesthesia ◽  
Anterior Cruciate ◽  
Loss Of Motion

Background: Loss of motion (LOM) remains a common complication after anterior cruciate ligament (ACL) reconstruction and can be detrimental to patient outcomes after surgery. LOM is multifactorial, but nonsurgical and surgical solutions to this complex problem are available. A paucity of quality data exists evaluating clinical outcomes after the surgical treatment of patients with LOM after ACL reconstruction. Hypothesis: Patients undergoing surgical lysis of adhesions and manipulation under anesthesia for LOM after ACL reconstruction will exhibit decreased function, lower outcome scores, and delayed time of release to play when compared with matched controls without LOM. Study Design: Cohort study; Level of evidence, 3 Methods: A database of 1572 patients undergoing ACL reconstruction was sampled from 2013 to 2017 to identify a total of 58 patients (LOM group [n = 29] vs matched control group [n = 29]). Group comparisons were examined for patients requiring a second surgical procedure for LOM versus matched controls after ACL reconstruction for differences in surgical timing, self-reported International Knee Disability Committee scores, objective function at release to play, and subjective knee function at 2 years with the Single Assessment Numeric Evaluation. The risk of a type I error was set at α = .05 for all statistical analyses. Results: Patients who underwent lysis of adhesions and manipulation under anesthesia for LOM after ACL reconstruction exhibited no differences in Single Assessment Numeric Evaluation knee function at 2 years when compared with matched controls (85.8 ± 14.9 vs 88.0 ± 10.8, P = .606). All patients met release-to-play criteria. Only International Knee Disability Committee scores ( P = .046) and single-legged hop testing ( P = .050) reached statistically significant differences, with higher scores in the control group. There was no difference in the time to release to play ( P = .034) or level of participation ( P = .180) between the control and surgical groups. Subjective function scores at 2 years were not significantly different between groups. Tourniquet time during the index ACL reconstruction was shorter in the control group ( P = .034). Conclusion: The findings of this study suggest that patients who undergo surgical treatment for LOM after ACL reconstruction can release to play at similar times but display relative deficits in single-legged-hop symmetry and lower self-reported function when compared with matched controls. Longer surgical times may increase the risk for LOM after ACL reconstruction. Registration: NCT03704376 (ClinicalTrials.gov identifier)

scholarly journals PS2-16: Surveillance for Anterior Cruciate Ligament Surgical Site Infections Using Claims Data

2012 ◽  
Vol 10 (3) ◽  
pp. 178-178
Author(s):  
M. Klompas ◽  
M. Murphy ◽  
D. Du ◽  
W. Hua ◽  
A. Von Worley ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Claims Data ◽  
Cruciate Ligament ◽  
Surgical Site Infections ◽  
Anterior Cruciate
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