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首页> 外文期刊>Clinical kidney journal. >A scheme based on ICD-10 diagnoses and drug prescriptions to stage chronic kidney disease severity in healthcare administrative records
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A scheme based on ICD-10 diagnoses and drug prescriptions to stage chronic kidney disease severity in healthcare administrative records

机译：基于ICD-10诊断和药物处方的计划，可在医疗保健行政记录中分阶段慢性肾脏疾病的严重程度

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Background Information about renal function is important for drug safety studies using administrative health databases. However, serum creatinine values are seldom available in these registries. Our aim was to develop and test a simple scheme for stratification of renal function without access to laboratory test results. Methods Our scheme uses registry data about diagnoses, contacts, dialysis and drug use. We validated the scheme in the Stockholm CREAtinine Measurements (SCREAM) project using information on approximately 1.1 million individuals residing in the Stockholm County who underwent calibrated creatinine testing during 2006–11, linked with data about health care contacts and filled drug prescriptions. Estimated glomerular filtration rate (eGFR) was calculated with the CKD-EPI formula and used as the gold standard for validation of the scheme. Results When the scheme classified patients as having eGFR 2, it was correct in 93.5% of cases. The specificity of the scheme was close to 100% in all age groups. The sensitivity was poor, ranging from 68.2% in the youngest age quartile, down to 10.7% in the oldest age quartile. Age-related decline in renal function makes a large proportion of elderly patients fall into the chronic kidney disease (CKD) range without receiving CKD diagnoses, as this often is seen as part of normal ageing. Conclusions In the absence of renal function tests, our scheme may be of value for identifying patients with moderate and severe CKD on the basis of diagnostic and prescription data for use in studies of large healthcare databases.
机译：有关肾功能的背景信息对于使用行政健康数据库进行药物安全性研究非常重要。但是，这些注册表中很少提供血清肌酐值。我们的目标是开发和测试一种简单的肾脏功能分层方案，而无需获得实验室测试结果。方法我们的计划使用有关诊断，联系方式，透析和吸毒的注册表数据。我们利用斯德哥尔摩县约110万居住在斯德哥尔摩郡的人的信息对该方案进行了验证，该人居住在斯德哥尔摩县，在2006-11年度期间接受了肌酐的校准测试，并与医疗保健联系和填充药物处方相关联。估算的肾小球滤过率（eGFR）用CKD-EPI公式计算，并用作验证方案的金标准。结果当该方案将患者分类为eGFR 2 时，在93.5％的情况下正确。该方案在所有年龄段的特异性都接近100％。敏感性很差，范围从最年轻的四分位数的68.2％到最老的四分位数的10.7％。与年龄有关的肾功能下降使大部分老年患者在未接受CKD诊断的情况下陷入慢性肾脏疾病（CKD）范围，因为这通常被视为正常衰老的一部分。结论在没有肾功能检查的情况下，我们的方案对于基于诊断和处方数据的大型中医数据库研究中识别出中度和重度CKD患者可能具有价值。

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