title: Validity of the clinical and administrative databases in detecting post-operative adverse events.
abstract: OBJECTIVE
  Patient safety has become a major public health concern and a priority for multiple institutions. Assessment of the adverse events is a key element for measuring the quality of healthcare organizations. The aim of this study was to measure the validity of the clinical and administrative database (CADB) as a source of information for the detection of post-operative adverse events.
  
  
  METHODS
  The study design was cross-sectional.
  
  
  METHODS
  The study was carried out at the Hospital de Navarra (north of Spain).
  
  
  METHODS
  The sample consisted of 1602 episodes of surgical hospitalization from nine surgical departments. Two sources of information were used: data extracted from the complete clinical record (CR), the gold standard, vs. the CADB.
  
  
  RESULTS
  Rate of adverse events, sensitivity, positive predictive value and κ index were analysed for 28 types of post-operative adverse event. Each index was considered acceptable if it had a value >0.6.
  
  
  RESULTS
  The rate of adverse events using the CADB was 12.5 vs. 24% using CR within 30 days of surgery (P = 0.0001) and 13.9% using CR during a hospital stay (P > 0.05). The overall sensitivity of the CADB in the detection of adverse events was 0.18, and the positive predictive value was 0.34. Two adverse events (accounted for 6% of the total events detected) had moderate validity and the rest poor validity. Forty-two per cent of the adverse events took place after patient discharge.
  
  
  CONCLUSIONS
  Although the use of CADB is appealing, the present study suggests that it is of very limited value in the detection of adverse events post-operatively.
authors.affiliation: Preventive Medicine and Quality Control Department, Complejo Hospitalario de Navarra, Servicio Navarro de Salud, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Pamplona, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Rodrigo-Rincon
authors.affiliation: Anaesthesia Department, Complejo Hospitalario de Navarra, Servicio Navarro de Salud, Pamplona, Spain.
authors.forename: Marta P
authors.initials: MP
authors.lastname: Martin-Vizcaino
authors.affiliation: Preventive Medicine and Quality Control Department, Complejo Hospitalario de Navarra, Servicio Navarro de Salud, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Pamplona, Spain.
authors.forename: Belen
authors.initials: B
authors.lastname: Tirapu-Leon
authors.affiliation: Preventive Medicine and Quality Control Department, Complejo Hospitalario de Navarra, Servicio Navarro de Salud, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Pamplona, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Zabalza-Lopez
authors.affiliation: Preventive Medicine and Quality Control Department, Complejo Hospitalario de Navarra, Servicio Navarro de Salud, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Pamplona, Spain.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Abad-Vicente
authors.affiliation: Vascular Department, Complejo Hospitalario de Navarra, Servicio Navarro de Salud, Pamplona, Spain.
authors.forename: Asuncion
authors.initials: A
authors.lastname: Merino-Peralta
mesh_terms: D003430:Cross-Sectional Studies; D016208:Databases, Factual / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D061214:Patient Safety / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000175:diagnosis* / Q000453:epidemiology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013030:Spain / Q000453:epidemiology
keywords: administrative databases; adverse events; personal medical records; validity