| アブストラクト | PURPOSE: Validating outcome measures is a prerequisite for using administrative databases for comparative effectiveness research. Although the Japanese Diagnosis Procedure Combination database is widely used in surgical studies, the outcome measure for postsurgical infection has not been validated. We developed a model to identify postsurgical infections using the routinely collected Diagnosis Procedure Combination data. METHODS: We retrospectively identified inpatients who underwent surgery for gastric, colon, or liver cancer between April 2016 and March 2018 at four hospitals. Chart reviews were conducted to identify postsurgical infections. We used bootstrap analysis with backwards variable elimination to select independent variables from routinely collected diagnosis and procedure data. Selected variables were used to create a score predicting the chart review-identified infections, and the performance of the score was tested. RESULTS: Among the 746 eligible patients, 96 patients (13%) had postoperative infections. Three variables were identified as predictors: diagnosis of infectious disease recorded as a complication arising after admission, addition of an intravenous antibiotic, and bacterial microscopy or culture. The prediction model had a C-statistic of 0.885 and pseudo-R(2) of 0.358. A cut-off of one point of the score showed a sensitivity of 92% and specificity of 72%, and a cut-off of two points showed a sensitivity of 75% and specificity of 91%. CONCLUSIONS: Our model using routinely collected administrative data accurately identified postoperative infections. Further external validation would lead to the application of the model for research using administrative databases. |
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| 投稿者 | Yamana, Hayato; Tsuchiya, Asuka; Horiguchi, Hiromasa; Morita, Shigeki; Kuroki, Tamotsu; Nakai, Kunio; Nishimura, Hideo; Jo, Taisuke; Fushimi, Kiyohide; Yasunaga, Hideo |
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| 組織名 | Department of Health Services Research, Graduate School of Medicine, The;University of Tokyo, Tokyo, Japan.;Department of Clinical Data Management and Research, Clinical Research Center,;National Hospital Organization Headquarters, Tokyo, Japan.;Department of Emergency and Critical Care Medicine, National Hospital;Organization Mito Medical Center, Ibarakimachi, Japan.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan.;National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.;National Hospital Organization Nagasaki Medical Center, Omura, Japan.;National Hospital Organization Minami Wakayama Medical Center, Tanabe, Japan.;National Hospital Organization Asahikawa Medical Center, Asahikawa, Japan.;Department of Health Policy and Informatics, Tokyo Medical and Dental University;Graduate School, Tokyo, Japan. |
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