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Validation of Administrative Database Codes for Acute Kidney Injury in Kidney Transplant Recipients

Overview of attention for article published in Canadian Journal of Kidney Health and Disease, April 2016
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3 tweeters

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20 Dimensions

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37 Mendeley
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Title
Validation of Administrative Database Codes for Acute Kidney Injury in Kidney Transplant Recipients
Published in
Canadian Journal of Kidney Health and Disease, April 2016
DOI 10.1186/s40697-016-0108-7
Pubmed ID
Authors

Amber O. Molnar, Carl van Walraven, Eric McArthur, Dean Fergusson, Amit X. Garg, Greg Knoll

Abstract

Validation studies of acute kidney injury (AKI) diagnostic codes performed in the general population have shown poor sensitivity, but the accuracy of such codes in the kidney transplant population remains unknown. The objective of this study is to determine the accuracy of AKI diagnostic codes in kidney transplant recipients. We hypothesized that the sensitivity of diagnostic codes would be significantly greater in the kidney transplant population since these patients are closely followed by nephrologists and are more likely to have serum creatinine measured. The design is a population-based retrospective cohort study using healthcare administrative and laboratory databases. The setting is in Southwestern Ontario and Ottawa, Ontario, Canada, from 2003 to 2012. We included first-time kidney transplant recipients admitted to hospital for whom serum creatinine was measured in hospital and within 6 months prior (n = 524). Patients meeting the Acute Kidney Injury Network (AKIN) classification serum creatinine change criteria were classified as having AKI. We determined the sensitivity, specificity, and negative and positive predictive values for the ICD-10-CA code for AKI when present as an admission diagnosis, most responsible diagnosis, or any diagnosis compared to a reference standard of AKI defined by the AKIN criteria (stage 1 or greater, stage 2 or greater, or stage 3). Forty-five percent of included kidney transplant patients had a diagnosis of AKI. The most sensitive coding algorithm (reference standard AKIN stage 2 or greater, ICD-10 code present as any diagnosis) had a sensitivity of 42.1 % (95 % CI 31.7, 53.3), a specificity of 90.6 % (95 % CI 87.6, 93.0), and a positive likelihood ratio of 4.5. The median (IQR) rise in serum creatinine from baseline in patients with and without AKI codes was 104 (57 to 158) μmol/L and 16 (-3 to 41) μmol/L, respectively (Mann-Whitney test, p < 0.0001). The low sensitivity of the AKI code may be due to an alternative diagnosis of acute rejection being assigned in certain cases. The cause of AKI could not be determined. Similar to the general population, the ICD-10 N17x code misses many kidney transplant patients with AKI during their hospitalization. This makes the code unusable for studying the incidence and consequences of AKI in hospitalized kidney transplant patients.

Twitter Demographics

The data shown below were collected from the profiles of 3 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 37 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 3%
Unknown 36 97%

Demographic breakdown

Readers by professional status Count As %
Researcher 10 27%
Other 5 14%
Student > Ph. D. Student 4 11%
Student > Postgraduate 4 11%
Student > Master 4 11%
Other 7 19%
Unknown 3 8%
Readers by discipline Count As %
Medicine and Dentistry 22 59%
Nursing and Health Professions 2 5%
Pharmacology, Toxicology and Pharmaceutical Science 1 3%
Linguistics 1 3%
Mathematics 1 3%
Other 5 14%
Unknown 5 14%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 07 April 2016.
All research outputs
#11,071,882
of 17,687,978 outputs
Outputs from Canadian Journal of Kidney Health and Disease
#292
of 384 outputs
Outputs of similar age
#144,248
of 271,224 outputs
Outputs of similar age from Canadian Journal of Kidney Health and Disease
#1
of 1 outputs
Altmetric has tracked 17,687,978 research outputs across all sources so far. This one is in the 35th percentile – i.e., 35% of other outputs scored the same or lower than it.
So far Altmetric has tracked 384 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.4. This one is in the 20th percentile – i.e., 20% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 271,224 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 43rd percentile – i.e., 43% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them