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Logo of bmcgastBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Gastroenterology
 
BMC Gastroenterol. 2012; 12: 39.
Published online Apr 27, 2012. doi:  10.1186/1471-230X-12-39
PMCID: PMC3432603
Postoperative complications following colectomy for ulcerative colitis: A validation study
Christopher Ma,1,2,3 Marcelo Crespin,1,2,3 Marie-Claude Proulx,1,2,3 Shanika DeSilva,4 James Hubbard,1,2,3 Martin Prusinkiewicz,1,2,3 Geoffrey C Nguyen,5 Remo Panaccione,1,2 Subrata Ghosh,1,2 Robert P Myers,1,2,3 Hude Quan,3 and Gilaad G Kaplancorresponding author1,2,3,5
1Inflammatory Bowel Disease Clinic, University of Calgary, Calgary, Alberta, Canada
2Departments of Medicine, University of Calgary, Calgary, Alberta, Canada
3Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
4Mount Sinai Hospital, University of Toronto School of Medicine, Toronto, Ontario, Canada
5Teaching Research and Wellness Center, 3280 Hospital Drive NW, 6D17, Calgary, AB, T2N 4N1, Canada
corresponding authorCorresponding author.
Christopher Ma: christopher.ma/at/ucalgary.ca; Marcelo Crespin: marcelo.crespin/at/ualberta.ca; Marie-Claude Proulx: mcproulx/at/ucalgary.ca; Shanika DeSilva: shanidesilva/at/mac.com; James Hubbard: jhubbard/at/ucalgary.ca; Martin Prusinkiewicz: mprusinkiewicz/at/gmail.com; Geoffrey C Nguyen: geoff.nguyen/at/utoronto.ca; Remo Panaccione: rpanacci/at/ucalgary.ca; Subrata Ghosh: ghosh/at/ucalgary.ca; Robert P Myers: rpmyers/at/ucalgary.ca; Hude Quan: hquan/at/ucalgary.ca; Gilaad G Kaplan: ggkaplan/at/ucalgary.ca
Received July 11, 2011; Accepted April 27, 2012.
Abstract
Background
Ulcerative colitis (UC) patients failing medical management require colectomy. This study compares risk estimates for predictors of postoperative complication derived from administrative data against that of chart review and evaluates the accuracy of administrative coding for this population.
Methods
Hospital administrative databases were used to identify adults with UC undergoing colectomy from 1996–2007. Medical charts were reviewed and regression analyses comparing chart versus administrative data were performed to assess the effect of age, emergent operation, and Charlson comorbidities on the occurrence of postoperative complications. Sensitivity, specificity, and positive/negative predictive values of administrative coding for identifying the study population, Charlson comorbidities, and postoperative complications were assessed.
Results
Compared to chart review, administrative data estimated a higher magnitude of effect for emergent admission (OR 2.52 [95% CI: 1.80–3.52] versus 1.49 [1.06–2.09]) and Charlson comorbidities (OR 2.91 [1.86–4.56] versus 1.50 [1.05–2.15]) as predictors of postoperative complications. Administrative data correctly identified UC and colectomy in 85.9% of cases. The administrative database was 37% sensitive in identifying patients with  1Charlson comorbidity. Restricting analysis to active comorbidities increased the sensitivity to 63%. The sensitivity of identifying patients with at least one postoperative complication was 68%; restricting analysis to more severe complications improved the sensitivity to 84%.
Conclusions
Administrative data identified the same risk factors for postoperative complications as chart review, but overestimated the magnitude of risk. This discrepancy may be explained by coding inaccuracies that selectively identifying the most serious complications and comorbidities.
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