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- W2795621417 abstract "No AccessJournal of UrologyAdult Urology1 Nov 2019Identifying and Codifying Complications after Radical Cystectomy: Comparison of Administrative Diagnostic and Procedure Codes, and Clinical Chart Review Charles C. Peyton, Richard R. Reich, Dominic Tang, Brandon Alford, Mounsif Azizi, Roger Li, Wade J. Sexton, Michael Poch, and Scott M. Gilbert Charles C. PeytonCharles C. Peyton Moffitt Cancer Center, Tampa, Florida More articles by this author , Richard R. ReichRichard R. Reich Moffitt Cancer Center, Tampa, Florida More articles by this author , Dominic TangDominic Tang Moffitt Cancer Center, Tampa, Florida More articles by this author , Brandon AlfordBrandon Alford School of Medicine, University of South Florida, Tampa, Florida More articles by this author , Mounsif AziziMounsif Azizi Moffitt Cancer Center, Tampa, Florida More articles by this author , Roger LiRoger Li Moffitt Cancer Center, Tampa, Florida More articles by this author , Wade J. SextonWade J. Sexton Moffitt Cancer Center, Tampa, Florida More articles by this author , Michael PochMichael Poch Moffitt Cancer Center, Tampa, Florida More articles by this author , and Scott M. GilbertScott M. Gilbert *Correspondence: Department of Genitourinary Oncology, Moffitt Cancer Center, 12902 Magnolia Dr., Tampa, Florida 33612 telephone: 813-745-8343, FAX: 813-745-8494; E-mail Address: [email protected] Moffitt Cancer Center, Tampa, Florida More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000398AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: To our knowledge the reliability of administrative claims codes to report postoperative radical cystectomy complications has not been examined. We compared complications identified by claims data to those abstracted from clinical chart review following radical cystectomy. Methods: We manually reviewed the charts of 268 patients treated with radical cystectomy between 2014 and 2016 for 30-day complications and queried administrative complication coding using 805 ICD-9/10 codes. Complications were categorized. Using Cohen κ statistics we assessed agreement between the 2 methods of complication reporting for 1 or more postoperative complications overall, categorical complications and complications stratified by the top quartile length of hospital stay and patients who were readmitted. Results: At least 1 or more complications were recorded in 122 patients (45.5%) through manual chart review and 80 (29.9%) were recorded via claim coding data with a concordance rate of κ=0.16, indicating weak agreement. Concordance was generally weak for categorical complication rates (range 0.05 to 0.36). However, when examining only the top length of stay quartile, 1 or more complications were reported in 32 patients (65%) by the manual chart review and in 12 (25%) via coding data with a concordance rate of κ=–0.2. Agreement was weak, similar to the total cohort. Conclusions: Manual chart review and claim code identification of complications are not highly concordant even when stratified by patients with an extended length of stay, who are known to have more frequent complications. Researchers and administrators should be aware of these differences and exercise caution when interpreting complication reports. References 1. : A comparison of postoperative complications in open versus robotic cystectomy. Eur Urol 2010; 57: 274. Google Scholar 2. : Defining early morbidity of radical cystectomy for patients with bladder cancer using a standardized reporting methodology. Eur Urol 2009; 55: 164. Google Scholar 3. : Urinary diversion and morbidity after radical cystectomy for bladder cancer. 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Google Scholar 23. : Sharpening the focus on causes and timing of readmission after radical cystectomy for bladder cancer. Cancer 2014; 120: 1409. Google Scholar 24. : Statistical Methods for Rates and Proportions, 3rd ed. Hoboken: Wiley 2003. Google Scholar 25. : Underlying reasons associated with hospital readmission following surgery in the United States. JAMA 2015; 313: 483. Google Scholar 26. : Standards for surgical complication reporting in urologic oncology: time for a change. Urology 2007; 69: 221. Google Scholar 27. : Identifying patient preoperative risk factors and postoperative adverse events in administrative databases: results from the Department of Veterans Affairs National Surgical Quality Improvement Program. J Am Coll Surg 2002; 194: 257. Google Scholar 28. : How best to measure surgical quality? 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Google Scholar The corresponding author certifies that, when applicable, a statement(s) has been included in the manuscript documenting institutional review board, ethics committee or ethical review board study approval; principles of Helsinki Declaration were followed in lieu of formal ethics committee approval; institutional animal care and use committee approval; all human subjects provided written informed consent with guarantees of confidentiality; IRB approved protocol number; animal approved project number. No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. © 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited bySmith J (2019) This Month in Adult UrologyJournal of Urology, VOL. 202, NO. 5, (837-839), Online publication date: 1-Nov-2019. Volume 202Issue 5November 2019Page: 913-919Supplementary Materials Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.KeywordsInternational Classification of Diseasesclinical codingcystectomyurinary bladderpostoperative complicationsAcknowledgmentBiwei Cao provided graphic support.MetricsAuthor Information Charles C. Peyton Moffitt Cancer Center, Tampa, Florida More articles by this author Richard R. Reich Moffitt Cancer Center, Tampa, Florida More articles by this author Dominic Tang Moffitt Cancer Center, Tampa, Florida More articles by this author Brandon Alford School of Medicine, University of South Florida, Tampa, Florida More articles by this author Mounsif Azizi Moffitt Cancer Center, Tampa, Florida More articles by this author Roger Li Moffitt Cancer Center, Tampa, Florida More articles by this author Wade J. Sexton Moffitt Cancer Center, Tampa, Florida More articles by this author Michael Poch Moffitt Cancer Center, Tampa, Florida More articles by this author Scott M. Gilbert Moffitt Cancer Center, Tampa, Florida *Correspondence: Department of Genitourinary Oncology, Moffitt Cancer Center, 12902 Magnolia Dr., Tampa, Florida 33612 telephone: 813-745-8343, FAX: 813-745-8494; E-mail Address: [email protected] More articles by this author Expand All The corresponding author certifies that, when applicable, a statement(s) has been included in the manuscript documenting institutional review board, ethics committee or ethical review board study approval; principles of Helsinki Declaration were followed in lieu of formal ethics committee approval; institutional animal care and use committee approval; all human subjects provided written informed consent with guarantees of confidentiality; IRB approved protocol number; animal approved project number. No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. Advertisement PDF downloadLoading ..." @default.
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