Validity of administrative data in identifying complex surgical site infections from a population-based cohort after primary hip and knee arthroplasty in Alberta, Canada

Publication date: Available online 27 April 2018
Source:American Journal of Infection Control
Author(s): Elissa Rennert-May, Braden Manns, Stephanie Smith, Shannon Puloski, Elizabeth Henderson, Flora Au, Kathryn Bush, John Conly
BackgroundSurgical site infections (SSIs) are a substantial burden to healthcare systems in North America. Administrative data is one method though which these may be identified, but the accuracy of using such data is uncertain.MethodsWe followed a population-based cohort of patients who received primary hip/knee arthroplasty in Alberta, Canada, for whom a comprehensive Infection Prevention and Control (IPC) prospective surveillance methodology was used to track SSIs. Patients were also followed using International Classification of Diseases, Tenth Revision (ICD-10) codes. We assessed the sensitivity/specificity and positive/negative predictive values of ICD-10 codes compared to IPC surveillance.ResultsBetween April 1, 2012, and March 31, 2015, 24,512 people received hip/knee arthroplasty. Of these, 258 (1.05%) had a complex SSI found by IPC surveillance. Sensitivity and specificity of ICD-10 codes in identifying complex SSIs after hip/knee arthroplasty were 85.3% (95% confidence interval [CI] 80.3%-89.4%) and 99.5% (95% CI 99.4%-99.6%), respectively. Positive and negative predictive values were 63.6% (95% CI 58.3%-68.7%) and 99.8% (95% CI 99.8%-99.9%), respectively.DiscussionAdministrative data have reasonable testing characteristics for identifying complex SSIs after arthroplasty. For centers without prospective surveillance programs, this could be useful in identifying hospitals with frequent complex SSIs after arthroplasty.ConclusionsA comprehensive IPC surveillance program is superior at detecting SSIs after arthroplasty.



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