1
|
Mellinghoff SC, Bruns C, Al-Monajjed R, Cornely FB, Grosheva M, Hampl JA, Jakob C, Koehler FC, Lechmann M, Maged B, Otto-Lambertz C, Rongisch R, Rutz J, Salmanton-Garcia J, Schlachtenberger G, Stemler J, Vehreschild J, Wülfing S, Cornely OA, Liss BJ. Harmonized procedure coding system for surgical procedures and analysis of surgical site infections (SSI) of five European countries. BMC Med Res Methodol 2022; 22:225. [PMID: 35962320 PMCID: PMC9374282 DOI: 10.1186/s12874-022-01702-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 08/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The use of routine data will be essential in future healthcare research. Therefore, harmonizing procedure codes is a first step to facilitate this approach as international research endeavour. An example for the use of routine data on a large scope is the investigation of surgical site infections (SSI). Ongoing surveillance programs evaluate the incidence of SSI on a national or regional basis in a limited number of procedures. For example, analyses by the European Centre for Disease Prevention (ECDC) nine procedures and provides a mapping table for two coding systems (ICD9, National Healthcare Safety Network [NHSN]). However, indicator procedures do not reliably depict overall SSI epidemiology. Thus, a broader analysis of all surgical procedures is desirable. The need for manual translation of country specific procedures codes, however, impedes the use of routine data for such an analysis on an international level. This project aimed to create an international surgical procedure coding systems allowing for automatic translation and categorization of procedures documented in country-specific codes. METHODS We included the existing surgical procedure coding systems of five European countries (France, Germany, Italy, Spain, and the United Kingdom [UK]). In an iterative process, country specific codes were grouped in ever more categories until each group represented a coherent unit based on method of surgery, interventions performed, extent and site of the surgical procedure. Next two ID specialist (arbitrated by a third in case of disagreement) independently assigned country-specific codes to the resulting categories. Finally, specialist from each surgical discipline reviewed these assignments for their respective field. RESULTS A total number of 153 SALT (Staphylococcus aureus Surgical Site Infection Multinational Epidemiology in Europe) codes from 10 specialties were assigned to 15,432 surgical procedures. Almost 4000 (26%) procedure codes from the SALT coding system were classified as orthopaedic and trauma surgeries, thus this medical field represents the most diverse group within the SALT coding system, followed by abdominal surgical procedures with 2390 (15%) procedure codes. CONCLUSION Mapping country-specific codes procedure codes onto to a limited number of coherent, internally and externally validated codes proofed feasible. The resultant SALT procedure code gives the opportunity to harmonize big data sets containing surgical procedures from international centres, and may simplify comparability of future international trial findings. TRIAL REGISTRATION The study was registered at clinicaltrials.gov under NCT03353532 on November 27th, 2017.
Collapse
Affiliation(s)
- Sibylle C Mellinghoff
- Department I for Internal Medicine, Excellence Centre for Medical Mycology (ECMM), University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany. .,Cologne Cluster of Excellence in Cellular Stress Responses in Aging-Associated Disease (CECAD), University of Cologne, Cologne, Germany. .,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.
| | - Caroline Bruns
- Department I for Internal Medicine, Excellence Centre for Medical Mycology (ECMM), University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany.,Cologne Cluster of Excellence in Cellular Stress Responses in Aging-Associated Disease (CECAD), University of Cologne, Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | | | - Florian B Cornely
- Department I for Internal Medicine, Excellence Centre for Medical Mycology (ECMM), University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Maria Grosheva
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | - Jürgen A Hampl
- Center of Neurosurgery, Department of General Neurosurgery, University Hospital Cologne, Cologne, Germany
| | - Carolin Jakob
- Department I for Internal Medicine, Excellence Centre for Medical Mycology (ECMM), University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Felix C Koehler
- Cologne Cluster of Excellence in Cellular Stress Responses in Aging-Associated Disease (CECAD), University of Cologne, Cologne, Germany.,Department II of Internal Medicine and Centre for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Max Lechmann
- Department of Trauma Surgery, Orthopaedic Surgery and Sports Traumatology, Witten/Herdecke University, Sana Medical Centre Cologne, Cologne, Germany
| | - Bijan Maged
- Department I for Internal Medicine, Excellence Centre for Medical Mycology (ECMM), University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Christina Otto-Lambertz
- Department of Orthopedics and Trauma, Surgery University Hospital of Cologne, Cologne, Germany
| | - Robert Rongisch
- Department of Dermatology and Venereology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Jule Rutz
- Department I for Internal Medicine, Excellence Centre for Medical Mycology (ECMM), University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Jon Salmanton-Garcia
- Cologne Cluster of Excellence in Cellular Stress Responses in Aging-Associated Disease (CECAD), University of Cologne, Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Georg Schlachtenberger
- Department of Thoracic and Cardiovascular Surgery, University Hospital of Cologne, Cologne, Germany
| | - Jannik Stemler
- Department I for Internal Medicine, Excellence Centre for Medical Mycology (ECMM), University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany.,Cologne Cluster of Excellence in Cellular Stress Responses in Aging-Associated Disease (CECAD), University of Cologne, Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Janne Vehreschild
- Department I for Internal Medicine, Excellence Centre for Medical Mycology (ECMM), University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany.,Cologne Cluster of Excellence in Cellular Stress Responses in Aging-Associated Disease (CECAD), University of Cologne, Cologne, Germany.,Department of Internal Medicine, Haematology/Oncology, Goethe University Frankfurt, Frankfurt, Germany
| | - Sophia Wülfing
- Department of Gynecology, Vivantes Klinikum Neukölln, Berlin, Germany
| | - Oliver A Cornely
- Department I for Internal Medicine, Excellence Centre for Medical Mycology (ECMM), University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany.,Cologne Cluster of Excellence in Cellular Stress Responses in Aging-Associated Disease (CECAD), University of Cologne, Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.,Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany
| | - Blasius J Liss
- Department I of Internal Medicine, Helios University Hospital Wuppertal, Wuppertal, Germany.,School of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany
| |
Collapse
|