医院艰难梭菌多中心监测研究（翻译有奖）

潮水

Multicenter Study of Surveillance for Hospital-Onset Clostridium difficile Infection by the Use of ICD-9-CM Diagnosis Codes
Infect Control Hosp Epidemiol 2010;31:262–268
Objective.To compare incidence of hospital-onset Clostridium difficile infection (CDI) measured by the use of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) discharge diagnosis codes with rates measured by the use of electronically available C. difficile toxin assay results.

Methods.Cases of hospital-onset CDI were identified at 5 US hospitals during the period from July 2000 through June 2006 with the use of 2 surveillance definitions: positive toxin assay results (gold standard) and secondary ICD-9-CM discharge diagnosis codes for CDI. The χ2 test was used to compare incidence, linear regression models were used to analyze trends, and the test of equality was used to compare slopes.

Results.Of 8,670 cases of hospital-onset CDI, 38% were identified by the use of both toxin assay results and the ICD-9-CM code, 16% by the use of toxin assay results alone, and 45% by the use of the ICD-9-CM code alone. Nearly half (47%) of cases of CDI identified by the use of a secondary diagnosis code alone were community-onset CDI according to the results of the toxin assay. The rate of hospital-onset CDI found by use of ICD-9-CM codes was significantly higher than the rate found by use of toxin assay results overall ( p<0.001), as well as individually at 3 of the 5 hospitals ( p<0.001for all). The agreement between toxin assay results and the presence of a secondary ICD-9-CM diagnosis code for CDI was moderate, with an overall κ value of 0.509 and hospital-specific κ values of 0.489–0.570. Overall, the annual increase in CDI incidence was significantly greater for rates determined by the use of ICD-9-CM codes than for rates determined by the use of toxin assay results (p=0.006 ).

Conclusions.Although the ICD-9-CM code for CDI seems to be adequate for measuring the overall CDI burden, use of the ICD-9-CM discharge diagnosis code for CDI, without present-on-admission code assignment, is not an acceptable surrogate for surveillance for hospital-onset CDI.

潮水

(ICD-9-CM)
世界卫生组织制定的国际疾病分类系统（International Classification of Diseases），目前是第十版。世界卫生组织制定的这套编码是为了疾病统计设计的。为了反映临床治疗，美国医疗和社会福利部对这套代码的第九版进行了修订（Clinical Modification）, 修订后的这套编码称为ICD-9-CM，共有13000个诊断码（ICD-9-CM Diagnosis Code）。

过年

本人英语水平有限，快译通翻译语法不通，等待高手翻译、分享.............