Clinical Epidemiology (Oct 2020)

Diagnosis of Open Tibial Fracture Showed High Positive Predictive Value in the Swedish National Patient Register

  • Tampe U,
  • Frank S,
  • Weiss RJ,
  • Jansson KÅ

Journal volume & issue
Vol. Volume 12
pp. 1113 – 1119

Abstract

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Ulrika Tampe, Sonny Frank, Rüdiger J Weiss, Karl-Åke Jansson Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Karolinska Institutet at Karolinska University Hospital, Stockholm, SwedenCorrespondence: Ulrika TampeKarolinska University Hospital, Solna, Stockholm 171 76, SwedenTel +46768188611Email [email protected]: The Swedish National Patient Register was validated only for a few diagnoses in the field of trauma. In this study, we calculated the positive predictive values (PPV) of the diagnosis of open tibial fracture and corresponding E-codes (cause of injury).Patients and Methods: Out of 2845 cases from a 10-year period (2007– 2016), a random sample of 300 cases was selected for review of medical records. The accuracy of the diagnosis and cause of injury was calculated and presented as PPV. We divided the study population into two subgroups (moderate and severe injury) that were analyzed separately. Severe injury was defined as when a patient had an amputation and/or reconstructive surgical procedures, indicated by corresponding ICD-codes.Results: The PPV of the diagnosis of open tibial fracture was 87% (95% CI: 86– 88%) overall, 86% (95% CI: 79– 91%) for moderate injuries and 96% (95% CI: 91– 98%) for severe injuries. The PPV for E-codes was 74% (95% CI: 65– 81%). The majority of injuries were caused by falls (47%) or transport accidents (38%). Most of these injuries were caused by high-energy trauma (60%).Conclusion: The PPV of the diagnosis of open tibial fracture in the Swedish National Patient Register is high (87%). The PPV of E-codes was lower (79%). The results imply that the register is well suited for healthcare evaluation and research purposes regarding trauma diagnoses. Most open tibial fractures are high-energy injuries.Keywords: cause of injury, diagnosis, open tibial fracture, positive predictive value, register study

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