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Can Hospital Discharge Diagnosis be used for Surveillance of Bacteremia? A Data Quality Study of a Danish Hospital Discharge Registry

Published online by Cambridge University Press:  31 March 2016

Kreesten Meldgaard Madsen ,
Henrik Carl Schønheyder ,
Brian Kristensen ,
Gunnar Lauge Nielsen  and
Henrik Toft Sørensen
Kreesten Meldgaard Madsen*
Affiliation:
Danish Epidemiology Science Centre at the Department of Epidemiology and Social Medicine, Aarhus University, Aarhus, Denmark Department of Clinical Microbiology, Aalborg Hospital, Aalborg, Denmark
Henrik Carl Schønheyder
Affiliation:
Department of Clinical Microbiology, Aalborg Hospital, Aalborg, Denmark
Brian Kristensen
Affiliation:
Department of Clinical Microbiology, Aalborg Hospital, Aalborg, Denmark
Gunnar Lauge Nielsen
Affiliation:
Danish Epidemiology Science Centre at the Department of Epidemiology and Social Medicine, Aarhus University, Aarhus, Denmark
Henrik Toft Sørensen
Affiliation:
Danish Epidemiology Science Centre at the Department of Epidemiology and Social Medicine, Aarhus University, Aarhus, Denmark Department of Internal Medicine V, Aarhus University Hospital, Aarhus, Denmark
*
Rosenvej 24, DK-8240 Risskov, Denmark
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Abstract

Objective:

To assess the data quality of septicemia and sepsis registration in a hospital discharge registry in the County of Northern Jutland, Denmark.

Design:

Comparison of data from the discharge registry of an 880-bed, public, urban hospital in the County of Northern Jutland with data from a computerized bac-teremia database at the regional department of clinical microbiology.

Setting:

Urban hospital with approximately 45,000 admissions per year.

Patients:

The study included 406 episodes of bac-teremia in the bacteremia database and 83 discharges with the diagnosis of septicemia registered in the hospital discharge registry between January 1, 1994, and December 31, 1994.

Interventions:

None.

Results:

Eighteen episodes were registered in both the hospital discharge registry and the bacteremia database. Using the bacteremia database as reference standard, the sensitivity for the diagnosis of septicemia in the hospital discharge registry was 4.4% (18/406; 95% confidence intervals [CI95, 2.4%-6.4%]). By review of hospital records, we estimated the positive predictive value of septicemia registration in the hospital discharge registry as 21.7% (18/83; CI95, 12.8%-30.5%). No blood culture had been obtained in 44.4% (36/81; CI95, 33.6%-55.3%) of the cases with a discharge diagnosis of septicemia. In 33.3% (27/81; CI95, 23.1%-43.6%), the discharge diagnosis of septicemia was given, although blood cultures were negative.

Conclusions:

The hospital discharge registry revealed numerous misclassifications, and the system was found not suited for surveillance of, or research in, bacteremia at present

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 19 , Issue 3 , March 1998 , pp. 175 - 180
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1998

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