Cases of Iatrogenic Pneumothorax Can Be Identified From ICD-9-CM Coded Data
- 11 May 2010
- journal article
- other
- Published by Wolters Kluwer Health in American Journal of Medical Quality
- Vol. 25 (3) , 218-224
- https://doi.org/10.1177/1062860609359534
Abstract
Hospital administrative data are being used to identify hospitals with hospital-acquired complications such as iatrogenic pneumothorax. This was a retrospective cross-sectional study of hospitalization records to estimate the positive predictive value (PPV) of the Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicator for iatrogenic pneumothorax. A probability sample of inpatient medical records from 2006 to 2007 was reviewed in a national sample of 28 volunteer hospitals. Among the 200 flagged cases, the PPV was 78% (95% confidence interval = 73%-82%). False positive cases were mostly a result of exclusionary conditions (11%) and pneumothoraxes that were present on admission (7%). About 44% of events followed attempted central venous catheter (CVC) placement. Of the 69 CVCassociated events, only 5 occurred with ultrasound guidance. AHRQ’s iatrogenic pneumothorax indicator can serve in quality of care improvement. At least 1725 hospital-acquired pneumothoraxes could have been prevented in 2004 through universal use of ultrasound guidance during internal jugular cannulation.Keywords
This publication has 15 references indexed in Scilit:
- Evaluation of the Agency for Healthcare Research and Quality Pediatric Quality IndicatorsPediatrics, 2008
- Do the AHRQ Patient Safety Indicators Flag Conditions That Are Present at the Time of Hospital Admission?Medical Care, 2008
- Impact of Diagnosis-Timing Indicators on Measures of Safety, Comorbidity, and Case Mix Groupings From Administrative Data SourcesMedical Care, 2007
- Pneumothorax after insertion of central venous catheters in the intensive care unit: association with month of year and week of monthQuality and Safety in Health Care, 2007
- Real-time ultrasound-guided catheterisation of the internal jugular vein: a prospective comparison with the landmark technique in critical care patientsCritical Care, 2006
- Patient safety: effect of institutional protocols on adverse events related to feeding tube placement in the critically illJournal of the American College of Surgeons, 2004
- Assessing accuracy of diagnosis-type indicators for flagging complications in administrative dataJournal of Clinical Epidemiology, 2004
- Excess Length of Stay, Charges, and Mortality Attributable to Medical Injuries During HospitalizationJAMA, 2003
- Ultrasonic locating devices for central venous cannulation: meta-analysisBMJ, 2003
- Subclavian venous catheterizationCritical Care Medicine, 1995