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COMPARISON OF PRIMARY THR INFECTION RATE AS PUBLISHED IN THE SCOTTISH ARTHROPLASTY 2006 REPORT WITH HOSPITAL STATISTICS.

Borders General Hospital, Melrose, Scotland.

Introduction: The Scottish Arthroplasty Project (SAP) publishes an annual report including infection rates post-arthroplasty having obtained their results from the patients’ ICD-10 codes. The aim of this project was to validate the THR infection rate for one unit as published in the 2006 Scottish Arthroplasty Project (SAP) Report.

Method: The details of the SAP results were obtained. The BGH keeps its own record of post-operative THR infections; only those that met the dates and criteria of the SAP 2006 report were included and compared. The ICD-10 coding status was analysed in more detail.

Results: Published rate of infection in the 2006 SAP report after total hip replacement is three times lower than the unit recorded. 12 patients were eligible (1.49% infection rate), the SAP report recorded 4 cases of infection.

The SAP searches for infection only using three ICD-10 codes. Six ICD-10 codes had been used to classify these 12 patients.

Discussion: A recent cardiac surgery study comparing postoperative mortality rates from hospital statistics with the central cardiac database statistics found an over reporting by the national central database.* We have found the reverse with a threefold under calculation in the national report. However the unreported figures still do not place BGH as an outlier. The reasons for the discrepancy are multifactorial; but include poor coding practice, narrow range of code searching and difficulties in diagnosing infection. This audit shows that investigating the results of not only the outlying units but also randomly picking those who appear to have excellent results is worthwhile.

Correspondence should be addressed to Mr Peter Howard, Editorial Secretary, BHS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE, England.