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UKRR – HES linkage James Fotheringham Sheffield Kidney Institute.

Published byIra Strickland Modified over 9 years ago

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Presentation on theme: "UKRR – HES linkage James Fotheringham Sheffield Kidney Institute."— Presentation transcript:

1 UKRR – HES linkage James Fotheringham Sheffield Kidney Institute

2 Why do this at all? Year of data collection Percentage Data Completeness for Comorbidity

3 USRDS Period prevalent dialysis patients age 20 & older. At the end of 1998 a new ICD-9-CM code was added for infections due to internal devices in peritoneal dialysis patients; data prior to this date are omitted. Infections in this category include those related to vascular access devices or peritoneal dialysis catheters. Dialysis patients, 2005, used as reference cohort. Rates adjusted for gender, race, & primary diagnosis.

4 Potential avenues it opens up Hospitalisation Procedures Location Diagnosis Superior position to USRDS in that we can describe events preRRT in < 65 year olds – Centre attributable outcomes

5 Linkage & Dataset & Fields 21,268 Incident RRT Patients 2002 - 2006 Hospitalisations, Procedures & Outpatient Episodes 1998 to Date Cause of Death & Location HES ANONYMISED

6 Comprehensive timeline DEATH FRACTURE PARATHYROIDECTOMY START OF RRT AVF FORMATION MI DIABETES HES Hospital Episode Statistics Ca Phos PTH Hb CHANGE IN MODALITY TENCKHOFF INSERTION L741 X411 M809 B142 E119 I21 0 1234 CABG X3 K423 -2 YEARS

7 DHSMR / SHMI-D 95% 99.8% Transplant Centre On Site Renal Services Visiting Renal Cover > 95% CI > 99.8% CI

8 Length of Stay & Frequency of Admission

9 Location of Admission

10 Better adjusted incident survival & practice characteristics influence it HES I21 - Myocardial Infarction HES E10 - Diabetes HES I71 - Peripheral Vasc. Dis. HES I50 – Cong. Cardiac Failure None COPD MI PVD DM CCF None COPD MI PVD DM CCF

11 Underpinning all this Comorbidity adjustment Insights into individual units own practice with relation to hospitalisation and how this differs from national practice Begin understanding if HES offers the answers to missing data Intuitive way of displaying centre specific data Demonstrating the utility of HES-linkage

12 Recognised pitfalls Undercoding and inaccuracies – Early focus will be describing robust endpoints Hospitalisation Location 30 Day Mortality Length of stay – Learn what the data can allow us to do

13 Progress to date Funding and authorisations are in place HRSS has the HES data UKRR will shortly be sending their data Combined dataset should arrive early August

14 Thank you

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