Incidence of Appendicitis over Time: A Comparative Analysis of an Administrative Healthcare Database and a Pathology-Proven Appendicitis RegistryReport as inadecuate




Incidence of Appendicitis over Time: A Comparative Analysis of an Administrative Healthcare Database and a Pathology-Proven Appendicitis Registry - Download this document for free, or read online. Document in PDF available to download.

Importance

At the turn of the 21st century, studies evaluating the change in incidence of appendicitis over time have reported inconsistent findings.

Objectives

We compared the differences in the incidence of appendicitis derived from a pathology registry versus an administrative database in order to validate coding in administrative databases and establish temporal trends in the incidence of appendicitis.

Design

We conducted a population-based comparative cohort study to identify all individuals with appendicitis from 2000 to2008.

Setting and Participants

Two population-based data sources were used to identify cases of appendicitis: 1 a pathology registry n = 8,822; and 2 a hospital discharge abstract database n = 10,453.

Intervention and Main Outcome

The administrative database was compared to the pathology registry for the following a priori analyses: 1 to calculate the positive predictive value PPV of administrative codes; 2 to compare the annual incidence of appendicitis; and 3 to assess differences in temporal trends. Temporal trends were assessed using a generalized linear model that assumed a Poisson distribution and reported as an annual percent change APC with 95% confidence intervals CI. Analyses were stratified by perforated and non-perforated appendicitis.

Results

The administrative database PPV = 83.0% overestimated the incidence of appendicitis 100.3 per 100,000 when compared to the pathology registry 84.2 per 100,000. Codes for perforated appendicitis were not reliable PPV = 52.4% leading to overestimation in the incidence of perforated appendicitis in the administrative database 34.8 per 100,000 as compared to the pathology registry 19.4 per 100,000. The incidence of appendicitis significantly increased over time in both the administrative database APC = 2.1%; 95% CI: 1.3, 2.8 and pathology registry APC = 4.1; 95% CI: 3.1, 5.0.

Conclusion and Relevance

The administrative database overestimated the incidence of appendicitis, particularly among perforated appendicitis. Therefore, studies utilizing administrative data to analyze perforated appendicitis should be interpreted cautiously.



Author: Stephanie Coward , Hashim Kareemi , Fiona Clement, Scott Zimmer, Elijah Dixon, Chad G. Ball, Steven J. Heitman, Mark Swain, Subra

Source: http://plos.srce.hr/



DOWNLOAD PDF




Related documents