Use of Hospital Episode Statistics to investigate abdominal aortic aneurysm surgery

Johal, Amundeep S.; Mitchell, David C.; Lees, Timothy; Cromwell, David; Meulen, Jan van der

doi:10.1002/bjs.7772

Cited by 20 publications

(21 citation statements)

References 20 publications

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“…Results from the first of these audits suggest that 10.5% of primary procedures are coded incorrectly although there was wide variation between different trusts and the inaccuracies did not necessarily mean that patients were categorised incorrectly 20 . Another study looking at aortic aneurysm surgery found that coding accuracy appeared to be high if diagnostic, operative and administrative codes were compared, and accuracy could be improved further if they were combined, 21 similar to our study.…”

Section: Discussionsupporting

confidence: 87%

Definitive management of gallstone pancreatitis in England

El-Dhuwaib¹,

Deakin²,

David³

et al. 2012

Ann R Coll Surg Engl

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INTRODUCTIONThe aim of this study was to investigate whether definitive treatment of gallstone pancreatitis (GSP) by either cholecystectomy or endoscopic sphincterotomy in England conforms with British Society of Gastroenterology (BSG) guidelines and to validate these guidelines.METHODSHospital Episode Statistics data were used to identify patients admitted for the first time with GSP between April 2007 and April 2008. These patients were followed until April 2009 to identify any who underwent definitive treatment or were readmitted with a further bout of GSP as an emergency.RESULTSA total of 5,454 patients were admitted with GSP between April 2007 and April 2008, of whom 1,866 (34.2%) underwent definitive treatment according to BSG guidelines, 1,471 on the index admission. Patients who underwent a cholecystectomy during the index admission were less likely to be readmitted with a further bout of GSP (1.7%) than those who underwent endoscopic sphincterotomy alone (5.3%) or those who did not undergo any form of definitive treatment (13.2%). Of those patients who did not undergo definitive treatment before discharge, 2,239 received definitive treatment following discharge but only 395 (17.6%) of these had this within 2 weeks. Of the 505 patients who did not undergo definitive treatment on the index admission and who were readmitted as an emergency with GSP, 154 (30.5%) were admitted during the 2 weeks immediately following discharge.CONCLUSIONSFollowing an attack of mild GSP, cholecystectomy should be offered to all patients prior to discharge. If patients are not fit for surgery, an endoscopic sphincterotomy should be performed as definitive treatment.

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Section: Discussionsupporting

confidence: 87%

Definitive management of gallstone pancreatitis in England

El-Dhuwaib¹,

Deakin²,

David³

et al. 2012

Ann R Coll Surg Engl

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“…10 The richness of the data also makes it possible to develop coding frameworks and data quality criteria to identify hospitals with divergent coding practices by combining diagnosis, procedure, and administrative codes. 16 A number of recent publications have demonstrated that when analysed carefully, HES is a valuable source of data to explore patterns of care as well as supporting epidemiological studies related to childbirth. [17][18][19] This study included half of all vaginal singleton term births in primiparous women who delivered in an NHS hospital over a 12-year period.…”

Section: Discussionmentioning

confidence: 99%

Third‐ and fourth‐degree perineal tears among primiparous women in England between 2000 and 2012: time trends and risk factors

Gurol‐Urganci

Cromwell

Edozien

et al. 2013

BJOG

338

270

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Objective To describe the trends of severe perineal tears in England and to investigate to what extent the changes in related risk factors could explain the observed trends.Design A retrospective cohort study of singleton deliveries from a national administrative database.Setting The English National Health Service between 1 April 2000 and 31 March 2012.Population A cohort of 1 035 253 primiparous women who had a singleton, term, cephalic, vaginal birth.Methods Multivariable logistic regression was used to estimate the impact of financial year of birth (labelled by starting year), adjusting for major risk factors.Main outcome measure The rate of third-degree (anal sphincter is torn) or fourth-degree (anal sphincter as well as rectal mucosa are torn) perineal tears.Results The rate of reported third-or fourth-degree perineal tears tripled from 1.8 to 5.9% during the study period. The rate of episiotomy varied between 30 and 36%. An increasing proportion of ventouse deliveries (from 67.8 to 78.6%) and non-instrumental deliveries (from 15.1 to 19.1%) were assisted by an episiotomy. A higher risk of third-or fourth-degree perineal tears was associated with a maternal age above 25 years, instrumental delivery (forceps and ventouse), especially without episiotomy, Asian ethnicity, a more affluent socio-economic status, higher birthweight, and shoulder dystocia.Conclusions Changes in major risk factors are unlikely explanations for the observed increase in the rate of third-or fourth-degree tears. The improved recognition of tears following the implementation of a standardised classification of perineal tears is the most likely explanation.Keywords Episiotomy, instrumental delivery, severe perineal trauma, trends, vaginal delivery.

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“…15 Administrative databases also lack the detail of clinical information systems or case notes, and it was not possible to control for risk factors that could not be recorded using ICD-10 codes, such as size of uterine cavity.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Rates of subsequent surgery following endometrial ablation among English women with menorrhagia: population‐based cohort study

Bansi‐Matharu

Gurol‐Urganci

Mahmood

et al. 2013

BJOG

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Objective To assess the risk of further surgery amongst women who had an initial endometrial ablation (EA) for the treatment of heavy menstrual bleeding (HMB).Design A retrospective cohort study using a national administrative database.Setting Population-based study of hospital care in the English National Health Service. Methods Multiple Cox regressions were performed to identify the risks of a further procedure, adjusted for age, social deprivation, year and type of initial EA, and presence of fibroids/polyps.Main outcome measures Time to repeat EA or hysterectomy after initial surgery.Results Of 114 910 women undergoing EA, 16.7% had at least one subsequent procedure within 5 years. Higher rates of subsequent surgery were associated with younger age at initial EA, with women aged under 35 years having an adjusted hazard ratio of 2.83 (95% CI 2.67-2.99), compared with women aged over 45 years. Women who had radiofrequency ablation were less likely to have subsequent surgery as compared with first-generation techniques (HR 0.69, 95% CI 0.63-0.76). The rate of a subsequent hysterectomy within 5 years was 13.5%. Younger women (OR 0.59, 95% CI 0.51-0.69) and those who had balloon, microwave, or radiofrequency ablation were less likely to have a second EA procedure, rather than a hysterectomy.Conclusions One in six women have further surgery after EA for HMB, which is a higher rate than reported in clinical trials. This risk of further surgery decreases with age.Keywords Endometrial ablation, heavy menstrual bleeding, hysterectomy.Please cite this paper as: Bansi-Matharu L, Gurol-Urganci I, Mahmood T, Templeton A, van der Meulen J, Cromwell D. Rates of subsequent surgery following endometrial ablation among English women with menorrhagia: population-based cohort study. BJOG 2013;120:1500-1507.

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Use of Hospital Episode Statistics to investigate abdominal aortic aneurysm surgery

Abstract: Coding consistency was high. The proposed framework could define homogeneous groups by combining diagnosis, procedure and administrative codes. It also allows an assessment of potential miscoding at national and hospital level.

Cited by 20 publications

References 20 publications

Definitive management of gallstone pancreatitis in England

Definitive management of gallstone pancreatitis in England

Third‐ and fourth‐degree perineal tears among primiparous women in England between 2000 and 2012: time trends and risk factors

Rates of subsequent surgery following endometrial ablation among English women with menorrhagia: population‐based cohort study

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