Identifying cardiac surgery operations in hospital episode statistics administrative database, with an OPCS-based classification of procedures, validated against clinical data

Abstract

ObjectivesAdministrative databases with dedicated coding systems in healthcare systems where providers are funded based on services recorded have been shown to be useful for clinical research, although their reliability is still questioned. We devised a custom classification of procedures and algorithms based on OPCS, enabling us to identify open heart surgeries from the English administrative database, Hospital Episode Statistics, with the objective of comparing the incidence of cardiac procedures in administrative and clinical databases.DesignA comparative study of the incidence of cardiac procedures in administrative and clinical databases.SettingData from all National Health Service Trusts in England, performing cardiac surgery.ParticipantsPatients classified as having cardiac surgery across England between 2004 and 2015, using a combination of procedure codes, age >18 and consultant specialty, where the classification was validated against internal and external benchmarks.ResultsWe identified a total of 296 426 cardiac surgery procedures, of which majority of the procedures were coronary artery bypass grafting (CABG), aortic valve replacement (AVR), mitral repair and aortic surgery. The matching at local level was 100% for CABG and transplant, >90% for aortic valve and major aortic procedures and >80% for mitral. At national level, results were similar for CABG (IQR 98.6%–104%), AVR (IQR 105%–118%) and mitral valve replacement (IQR 86.2%–111%).ConclusionsWe set up a process which can identify cardiac surgeries in England from administrative data. This will lead to the development of a risk model to predict early and late postoperative mortality, useful for risk stratification, risk prediction, benchmarking and real-time monitoring. Once appropriately adjusted, the system can be applied to other specialties, proving especially useful in those areas where clinical databases are not fully established.

Total hip arthroplasty versus hemiarthroplasty for independently mobile older adults with intracapsular hip fractures

“…those reduced and discharged home directly from the Emergency Department) might not have been captured by our study. Previous work in other surgical settings has found that OPCS4 codes in HES can reliably be used to identify some operations, although this can vary substantially between procedures [39]. However, a range of codes were used to define “revision surgery” and this selection might have influenced the findings.…”

Effect of the SARS-CoV-2 pandemic on mortality related to high-risk emergency and major elective surgery

“…The Hospital Episode Statistics (HES) Admitted Patient Care database was interrogated to identify admitted care episodes for adult patients with diagnostic codes relating to high-risk emergency general surgical (EGS) conditions (defined by an associated crude mortality rate greater than 5 per cent 4 , 5 including gastrointestinal ulcer; hernia, bowel ischaemia, bowel obstruction, diverticulitis, peritonitis, liver and biliary conditions, and miscellaneous; Table S1 and Appendix S1 ), and major elective surgery across several surgical subspecialties (colectomy, any rectal resection (proctectomy) 6 , cystectomy (bladder) 7 , oesophagectomy, gastrectomy, pancreatectomy, coronary artery bypass graft) 8 , open abdominal aortic aneurysm (AAA) repair 9 , endovascular aortic aneurysm repair (EVAR) 9 , and carotid endarterectomy 10 ; Table S2 and Appendix S1 ) 11 , 12 .…”

Outcome Monitoring After Cardiac Surgery (OMACS): a single-centre prospective cohort study of cardiac surgery patients

“…This is in line with findings from other centres. 20 Further, where OPCS codes are correct, they often do not provide enough granular detail about the operation type for use in research.…”