The positive predictive value of ankle fracture diagnosis in the Danish National Patient Registry

INTRODUCTION

Information on data validity is essential for understanding the precision of studies based on data from the Danish National Patient Registry (DNPR). Thus, the aim of this study was to validate the quality of ankle fracture data in the DNPR.

METHODS

We identified all patients from four hospitals with a surgically treated ankle fracture between 1 January 2018 and 31 December 2018. The positive predictive value (PPV) was estimated for a random sample of 10% of patients with both a relevant ankle fracture diagnosis code and a relevant procedure code, as well as for patients with only a relevant ankle fracture diagnosis code or a relevant ankle fracture procedure code. We collected data from medical records and X-rays. Two consultants independently validated the ankle fracture diagnosis and procedure codes reported to the DNPR.

RESULTS

Among the four centres, 651 patients were identified with both an ankle fracture diagnosis and a procedure code. Among these, data from 65 (10%) patients were extracted for validation. For these patients, the PPV for an ankle fracture was 0.95 (95% confidence interval (CI): 0.88-0.99). The PPV for the diagnosis code was 0.89 (95% CI: 0.79-0.95), and for the procedure code, the PPV was 0.82 (95% CI: 0.70-0.90). For patients with only an ankle fracture diagnosis code or only a surgical procedure code, the PPV for an ankle fracture was 0.77 (95% CI: 0.64-0.87).

CONCLUSION

This study showed that ankle fracture diagnosis and procedure codes registered in the DNPR are of a high quality and thus constitute a valuable data source for research on ankle fractures.

FUNDING

none.

TRIAL REGISTRATION

The Danish Data Protection Agency approved the study (journal number 2015-18/62866).

Quality of life and level of post-traumatic stress disorder among trauma patients: A comparative study between a regional and a university hospital

BACKGROUND

The aim of this study was to assess outcome in long-term quality of life (QoL) and post-traumatic stress disorder (PTSD) among adult survivors of trauma. Secondary aim was to compare levels of the outcome with injury severity and specialization level of two trauma centres.

METHODS

A retrospective study included patients received by the trauma response teams at two hospitals in 2013 aged 18 or more at follow-up. We assessed QoL and PTSD with one mailed questionnaire to each patient at either 12 or 24 months of follow-up. Health status was measured by EuroQol EQ-5D and the Glasgow Outcome Scale. PTSD symptoms were classified according to the Post-Traumatic Stress Disorder Checklist (PCL) and Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV).

RESULTS

A questionnaire was mailed to 774 patients at end of 2014 or early 2015, 455 were included for analysis; median age 44 (IQR 25-57; 68% male); median NISS 9 (IQR 2-17); At follow-up 24% (95% CI 20-28) reported a EQ index score value equivalent to the lowest 2.3% in the Danish population norm. Probable PTSD was present in 19% (95% CI 13-27) of patients with severe injuries (NISS> 15), and 23% (95% CI 19-28) of those with NISS < 15.

CONCLUSION

Severe trauma has substantial impact on QoL and PTSD assessed at 12-24 months after the trauma. The QoL was well below the Danish population norm. The presence of PTSD was independent of injury severity. Trauma Centres should consider to include this as part of the treatment principles.