Abstract: TH-PO966
Validation of Living Donor Nephrectomy Codes
Session Information
- Live Donor Outcomes and Kidney Transplantation in Pediatric and Ethnic/Racial Groups
November 02, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Transplantation
- 1702 Transplantation: Clinical and Translational
Authors
- Lam, Ngan, University of Alberta, Edmonton, Alberta, Canada
- Lentine, Krista L., Saint Louis University, St. Louis, Missouri, United States
- Klarenbach, Scott, University of Alberta, Edmonton, Alberta, Canada
- Sood, Manish M., Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Kuwornu, John Paul, Institute for Clinical Evaluative Sciences, London, Ontario, Canada
- Naylor, Kyla Lynn, Institute for Clinical Evaluative Sciences, University of Toronto, London, Ontario, Canada
- Knoll, Greg A., Ottawa Hospital , Ottawa, Ontario, Canada
- Kim, Joseph, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
- Garg, Amit X., London Health Sciences Centre, London, Ontario, Canada
Background
Use of administrative data for outcomes assessment in living kidney donors is increasing given the rarity of post-donation complications and challenges with loss to follow-up.
Methods
Using linked healthcare administrative databases in Ontario, Canada, we conducted a retrospective cohort study to determine the validity of diagnostic and procedural codes for living donor nephrectomies. The reference standard was living kidney donation events identified through the province’s tissue and organ procurement agency, with verification by manual chart review. All living kidney donors from 2003 to 2010 who had donated at one of five major transplantation centers in Ontario were included. Operating characteristics (sensitivity and positive predictive value, PPV) of various algorithms using diagnostic, procedural, and physician billing codes were calculated.
Results
During the study period, there were a total of 1199 living donor nephrectomies performed. Overall, the best algorithm for identifying living kidney donors was the presence of one diagnostic code for kidney donor (ICD-10 Z52.4) and one procedural code for kidney procurement or excision during a hospital admission (1PC58, 1PC89, 1PC91). Compared to the reference standard, this algorithm had a sensitivity of 97.4% and a PPV of 90.1%. The diagnostic and procedural codes performed better than the physician billing codes (sensitivity 60.1%, PPV 78.3%).
Conclusion
An algorithm consisting of one diagnostic and one procedural code accurately identified living kidney donors in administrative databases. This algorithm can be used to identify and follow living kidney donors for post-donation outcomes.