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Estimating the contribution of respiratory pathogens to acute exacerbations of COPD using routine data

Shanya Sivakumaran, Mohammad Al Sallakh Orcid Logo, Ronan Lyons Orcid Logo, Jennifer K. Quint Orcid Logo, Gwyneth Davies Orcid Logo

Journal of Infection, Volume: 86, Issue: 3, Pages: 233 - 238

Swansea University Authors: Shanya Sivakumaran, Mohammad Al Sallakh Orcid Logo, Ronan Lyons Orcid Logo, Gwyneth Davies Orcid Logo

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Abstract

Objectives: To characterise microbiology testing and results associated with emergency admissions for acute exacerbation of COPD (AECOPD), and determine the accuracy of ICD-10 codes in retrospectively identifying laboratory-confirmed respiratory pathogens in this setting.Methods: Using person-level...

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Published in: Journal of Infection
ISSN: 0163-4453
Published: Elsevier BV 2023
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa62439
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Abstract: Objectives: To characterise microbiology testing and results associated with emergency admissions for acute exacerbation of COPD (AECOPD), and determine the accuracy of ICD-10 codes in retrospectively identifying laboratory-confirmed respiratory pathogens in this setting.Methods: Using person-level data from the Secure Anonymised Information Linkage Databank in Wales, we extracted emergency admissions for COPD from 1/12/2016 to 30/11/2018 and undertook linkage of admissions data to microbiology data to identify laboratory-confirmed infection. We further used these data to assess the accuracy of pathogen-specific ICD-10 codes.Results: We analysed data from 15,950 people who had 25,715 emergency admissions for COPD over the two-year period. 99.5% of admissions could be linked to a laboratory test within 7 days of admission date. Sputum was collected in 5,013 (19.5%) of admissions, and respiratory virus testing in 1,219 (4.7%). Where respiratory virus testing was undertaken, 46.7% returned any positive result. Influenza was the virus most frequently detected, in 21.5% of admissions where testing was conducted. ICD-10 codes exhibited low sensitivity in detecting laboratory-confirmed respiratory pathogens.Conclusions: In people admitted to hospital with AECOPD, increased testing for respiratory viruses could enable more effective antibiotic stewardship and isolation of cases. Linkage with microbiology data achieves more accurate and reliable case definitions.
Keywords: Respiratory Tract Infections, Pulmonary Disease, Chronic Obstructive, Electronic Health Records.
College: Faculty of Medicine, Health and Life Sciences
Funders: This study was funded by Swansea University Medical School with the support of BREATHE – The Health Data Research Hub for Respiratory Health [MC_PC_19004], which is funded through the UK Research and Innovation Industrial Strategy Challenge Fund and delivered through Health Data Research UK.
Issue: 3
Start Page: 233
End Page: 238