Technical Note: Prostatectomy Readmission

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Technical Note
Prostatectomy Readmission

Unit of Analysis:

The unit of analysis is an "Episode of care". An episode of care refers to all contiguous in-patient hospitalizations and same-day surgery visits. For episodes with transfers within or between facilities, transactions were linked regardless of diagnoses. To construct an episode of care a transfer is assumed to have occurred if either of the following conditions is met:

  • Acute care hospitalization or same day surgery visit occurs within 6 hours of discharge from previous acute care hospitalization or same day surgery visit regardless of whether the transfer is coded;
  • Acute care hospitalization or same day surgery visit occurs within 6-12 hours of discharge from previous acute care hospitalization or same day surgery visit and at least one of the hospitalization or visit has coded the transfer.

Denominator (Index Episode)

Inclusion Criteria:

  1. Prostatectomy1 CCP codes of 72.1^, 72.2^, 72.3^ or 72.5^ or ICD-9-CM codes of 60.2^-60.4^, 60.6^ or CCI codes of 1.QT.59^^, 1.QT.87^^
  2. Discharge between April 1 and March 3 of the following year (period of case selection ends March 3 to allow for 28 days of follow-up)
  3. Age at admission between 15 and 84 years
  4. Gender recorded as male
  5. Admission to an acute care institution or same day surgery facility
  6. Canadian resident

Exclusion Criteria:

  1. Records with an invalid Health Card Number
  2. Records with an invalid date of birth
  3. Records with an invalid admission date or time
  4. Records with an invalid discharge date or time
  5. CCP codes of 72.1^, 72.2^, 72.3^, or 72.5^ in conjunction with 72.4^ (radical prostatectomy) or ICD-9-CM codes 60.2^-60.4^, 60.6^ in conjunction with 60.5^ or CCI codes of 1.QT.59^^, 1.QT.87^^ in conjunction with 1.QT.91^^
  6. Discharged as a death or self sign-out
  7. Any one of the following diagnoses recorded in any position:
    1. Cancer (ICD-9/ICD-9-CM: 140-208, V58.1, V58.0 or ICD-10-CA: C00-C26, C30-C44, C45-C97, Z51.0, Z51.1)
    2. HIV (ICD-9: 042, 043, 044, 795.8 or ICD-9-CM: 042, 043, 044, 795.71, V08 or ICD-10-CA: B24, Z21, R75)
    3. Trauma (ICD-9/ICD-9-CM: E800-848, E880-886, E888, E890-899, E900-910, E913-926, E928, E950-958, E960-968, E970-976, E990-998 or ICD-10-CA: V01-V99, W00-W23, X00-X09, W92-W94, X17, X30, X31, X51, X53, X54, X57, X20-X29, W50-W60, X33-X38, W30, W31, W44, W45, W64-W77, W81-W84, W25-W27, W33-W40, W85-W99, X10-X19, X60-X84, X85-Y09, Y35.0-Y35.4, Y35.6, Y35.7, Y36)

Numerator

Inclusion Criteria:

  1. Readmission within 28 days of discharge after the index episode of care
  2. Emergent or urgent (non-elective) readmission to an acute care hospital
  3. Readmission for any one of the following procedures1:
    1. Operations on the Ureter (CCP: 68 or ICD-9-CM: 56 or CCI: 1.PE.50, 1.PE.52, 1.PE.54-1.PE.57, 1.PE.59, 1.PE.76, 1.PE.77, 1.PE.80, 1.PE.82, 1.PE.87, 1.PE.89, 1.PG.50, 1.PG.52, 1.PG.54-1.PG.57, 1.PG.59, 1.PG.72, 1.PG.74, 1.PG.76, 1.PG.77, 1.PG.80, 1.PG.82, 1.PG.86, 1.PG.87, 1.PG.89, 2.PG.70, 2.PG.71, 2.PE.70, 2.PE.71)
    2. Operations on the urinary bladder (CCP: 69 or ICD-9-CM: 57 or CCI: 1.PL.50, 1.PL.53, 1.PL.54, 1.PL.55, 1.PL.59, 1.PL.72, 1.PL.74, 1.PL.80, 1.PL.87, 1.PM.50, 1.PM.52, 1.PM.53, 1.PM.54-1.PM.59, 1.PM.72, 1.PM.73 1.PM.77, 1.PM.80, 1.PM.82, 1.PM.84, 1.PM.86, 1.PM.87, 1.PM.89-1.PM.92, 2.PM.70, 2.PM.71)
    3. Operations on the urethra (CCP: 70 or ICD-9-CM: 58 or CCI: 1.PQ.50, 1.PQ.52-1.PQ.57, 1.PQ.59, 1.PQ.72, 1.PQ.77, 1.PQ.78, 1.PQ.80, 1.PQ.82, 1.PQ.86, 1.PQ.87, 1.PQ.89, 2.PQ.70, 2.PQ.71)
    4. Operations on the urinary tract (CCP: 71 or ICD-9-CM: 59 or CCI: 1.PV.50, 1.PV.57, 1.PV.59, 1.PZ.94, 2.PV.70)
    5. Operations on the prostate and seminal vesicles (CCP: 72 or ICD-9-CM: 60 or CCI: 1.QQ.52, 1.QQ.87, 1.QQ.89, 1.QT.50-1.QT.57, 1.QT.59, 1.QT.87, 1.QT.91, 1.QZ.94, 2.QQ.70, 2.QQ.71, 2.QT.70, 2.QT.71)

      OR
      Readmission for any of the following most responsible diagnoses:
    6. Intestinal infections, other specified bacteria (ICD-9/ICD9-CM: 008.4 or ICD-10-CA: A04.5-A04.8)
    7. Pneumococcal pneumonia (ICD-9/ICD9-CM: 481 or ICD-10-CA: J13, J18.1; excluding cases where ICD-9/ICD9-CM: 496 or ICD-10-CA: J44 is also recorded in any diagnosis position)
    8. Other bacterial pneumonia (ICD-9/ICD9-CM: 482 or ICD-10-CA: J14, J15.0-J15.6, J15.8, J15.9; excluding cases where ICD-9/ICD9-CM: 496 or ICD-10-CA: J44) is also recorded in any diagnosis position)
    9. Bronchopneumonia, organism unspecified (ICD-9/ICD9-CM: 485 or ICD-10-CA: J18.0; excluding cases where ICD-9/ICD9-CM: 496 or ICD-10-CA: J44 is also recorded in any diagnosis position)
    10. Pneumonia, organism unspecified (ICD-9/ICD9-CM: 486 or ICD-10-CA: J18.8, J18.9; excluding cases where ICD-9/ICD9-CM: 496 or ICD-10-CA: J44 is also recorded in any diagnosis position)
    11. Urinary tract infection, site not specified (ICD-9/ICD9-CM: 599.0 or ICD-10-CA: N39.0)
    12. Hematuria (ICD-9/ICD9-CM: 599.7 or ICD-10-CA: N02, R31)
    13. Prostatic hypertrophy (ICD-9/ICD9-CM: 600 or ICD-10-CA: N40)
    14. Retention of urine (ICD-9/ICD9-CM: 788.2 or ICD-10-CA: R33, R39.12)
    15. Cardiac complications during or resulting from a procedure (ICD-9/ICD9-CM: 997.1 or ICD-10-CA: I97.8, I97.9)
    16. Respiratory complications resulting from a procedure (ICD-9: 997.3 or ICD9-CM: 997.3, 512.1 or ICD-10-CA: J95.4, J95.8, J95.9)
    17. Postoperative infection (ICD-9/ICD9-CM: 998.5 or ICD-10-CA: T81.4)

1 Code may be recorded in any position.  Procedures coded as cancelled, previous and “abandoned after onset” are excluded.