Exploring in-hospital adverse drug events using ICD-10 codes

 Abstract
Objective Adverse drug events (ADEs) during hospital admissions are a widespread problem associated with adverse patient outcomes. The ‘external cause’ codes in the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) provide opportunities for identifying the incidence of ADEs acquired during hospital stays that may assist in targeting interventions to decrease their occurrence. The aim of the present study was to use routine administrative data to identify ADEs acquired during hospital admissions in a suburban healthcare network in Melbourne, Australia.

Methods Thirty-nine secondary diagnosis fields of hospital discharge data for a 1-year period were reviewed for ‘diagnoses not present on admission’ and assigned to the Classification of Hospital Acquired Diagnoses (CHADx) subclasses. Discharges with one or more ADE subclass were extracted for retrospective analysis.

Results From 57 205 hospital discharges, 7891 discharges (13.8%) had at least one CHADx, and 402 discharges (0.7%) had an ADE recorded. The highest proportion of ADEs was due to administration of analgesics (27%) and systemic antibiotics (23%). Other major contributors were anticoagulation (13%), anaesthesia (9%) and medications with cardiovascular side-effects (9%).

Conclusion Hospital data coded in ICD-10 can be used to identify ADEs that occur during hospital stays and also clinical conditions, therapeutic drug classes and treating units where these occur. Using the CHADx algorithm on administrative datasets provides a consistent and economical method for such ADE monitoring.

What is known about the topic? Adverse drug events (ADEs) can result in several different physical consequences, ranging from allergic reactions to death, thereby posing a significant burden on patients and the health system. Numerous studies have compared manual, written incident reporting systems used by hospital staff with computerised automated systems to identify ADEs acquired during hospital admissions. Despite various approaches aimed at improving the detection of ADEs, they remain under-reported, as a result of which interventions to mitigate the effect of ADEs cannot be initiated effectively.

What does this paper add? This research article demonstrates major methodological advances over comparable published studies looking at the effectiveness of using routine administrative data to monitor rates of ADEs that occur during a hospital stay and reviews the type of ADEs and their frequency patterns during patient admission. It also provides an insight into the effect of ADEs that occur within different hospital treating units. The method implemented in this study is unique because it uses a grouping algorithm developed for the Australian Commission on Safety and Quality in Health Care (ACSQHC) to identify ADEs not present on admission from patient data coded in ICD-10. This algorithm links the coded external causes of ADEs with their consequences or manifestations. ADEs identified through the use of programmed code based on this algorithm have not been studied in the past and therefore this paper adds to previous knowledge in this subject area.

What are the implications for health professionals? Although not all ADEs can be prevented with current medical knowledge, this study can assist health professionals in targeting interventions that can efficiently reduce the rate of ADEs that occur during a hospital stay, and improve information available for future medication management decisions.

Arithmetic fuchsian groups and space time block codes

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Goppa and Srivastava codes over finite rings

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Alternant and BCH codes over certain rings

Alternant codes over arbitrary finite commutative local rings with identity are constructed in terms of parity-check matrices. The derivation is based on the factorization of x s - 1 over the unit group of an appropriate extension of the finite ring. An efficient decoding procedure which makes use of the modified Berlekamp-Massey algorithm to correct errors and erasures is presented. Furthermore, we address the construction of BCH codes over Zm under Lee metric.

Constructions of codes through the semigroup ring B[X; 1/2(2)Z(0)] and encoding

For any finite commutative ring B with an identity there is a strict inclusion B[X; Z(0)] subset of B[X; Z(0)] subset of B[X; 1/2(2)Z(0)] of commutative semigroup rings. This work is a continuation of Shah et al. (2011) [8], in which we extend the study of Andrade and Palazzo (2005) [7] for cyclic codes through the semigroup ring B[X; 1/2; Z(0)] In this study we developed a construction technique of cyclic codes through a semigroup ring B[X; 1/2(2)Z(0)] instead of a polynomial ring. However in the second phase we independently considered BCH, alternant, Goppa, Srivastava codes through a semigroup ring B[X; 1/2(2)Z(0)]. Hence we improved several results of Shah et al. (2011) [8] and Andrade and Palazzo (2005) [7] in a broader sense. Published by Elsevier Ltd

Geometrically uniform hyperbolic codes

In this paper we generalize the concept of geometrically uniform codes, formerly employed in Euclidean spaces, to hyperbolic spaces. We also show a characterization of generalized coset codes through the concept of G-linear codes.

The symmetry group of Z(q)(n) in the Lee space and the Z(qn)-linear codes

The Z(4)-linearity is a construction technique of good binary codes. Motivated by this property, we address the problem of extending the Z(4)-linearity to Z(q)n-linearity. In this direction, we consider the n-dimensional Lee space of order q, that is, (Z(q)(n), d(L)), as one of the most interesting spaces for coding applications. We establish the symmetry group of Z(q)(n) for any n and q by determining its isometries. We also show that there is no cyclic subgroup of order q(n) in Gamma(Z(q)(n)) acting transitively in Z(q)(n). Therefore, there exists no Z(q)n-linear code with respect to the cyclic subgroup.

Hamming and Reed-Solomon codes over certain rings

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Relating propelinear and binary G-linear codes

In this paper we establish the connections between two different extensions of Z(4)-linearity for binary Hamming spaces, We present both notions - propelinearity and G-linearity - in the context of isometries and group actions, taking the viewpoint of geometrically uniform codes extended to discrete spaces. We show a double inclusion relation: binary G-linear codes are propelinear codes, and translation-invariant propelinear codes are G-linear codes. (C) 2002 Elsevier B.V. B.V. All rights reserved.

On the construction of perfect codes from HEX signal constellations

Recently, minimum and non-minimum delay perfect codes were proposed for any channel of dimension n. Their construction appears in the literature as a subset of cyclic division algebras over Q(zeta(3)) only for the dimension n = 2(s)n(1), where s is an element of {0,1}, n(1) is odd and the signal constellations are isomorphic to Z[zeta(3)](n) In this work, we propose an innovative methodology to extend the construction of minimum and non-minimum delay perfect codes as a subset of cyclic division algebras over Q(zeta(3)), where the signal constellations are isomorphic to the hexagonal A(2)(n)-rotated lattice, for any channel of any dimension n such that gcd(n,3) = 1. (C) 2012 The Franklin Institute. Published by Elsevier Ltd. All rights reserved.

Genetic Algorithms (Binary and Real Codes) for the Optimisation of a Fermentation Process for Butanol Production

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Special subsets and optimum codes based on lattices and cosets

This paper introduces the concept of special subsets when applied to generator matrices based on lattices and cosets as presented by Calder-bank and Sloane. By using the special subsets we propose a non exhaustive code search for optimum codes. Although non exhaustive, the search always results in optimum codes for given (k1, V, Λ/Λ′). Tables with binary and ternary optimum codes to partitions of lattices with 8, 9 e 16 cosets, were obtained.

Construction and decoding of BCH codes over finite commutative rings

BCH codes over arbitrary finite commutative rings with identity are derived in terms of their locator vector. The derivation is based on the factorization of xs -1 over the unit ring of an appropriate extension of the finite ring. We present an efficient decoding procedure, based on the modified Berlekamp-Massey algorithm, for these codes. The code construction and the decoding procedures are very similar to the BCH codes over finite integer rings. © 1999 Elsevier B.V. All rights reserved.

Lattice constellations and codes from quadratic number fields

We propose new classes of linear codes over integer rings of quadratic extensions of Q, the field of rational numbers. The codes are considered with respect to a Mannheim metric, which is a Manhattan metric modulo a two-dimensional (2-D) grid. In particular, codes over Gaussian integers and Eisenstein-Jacobi integers are extensively studied. Decoding algorithms are proposed for these codes when up to two coordinates of a transmitted code vector are affected by errors of arbitrary Mannheim weight. Moreover, we show that the proposed codes are maximum-distance separable (MDS), with respect to the Hamming distance. The practical interest in such Mannheim-metric codes is their use in coded modulation schemes based on quadrature amplitude modulation (QAM)-type constellations, for which neither the Hamming nor the Lee metric is appropriate.

COX24 codes for a mitochondrial protein required for processing of the COX1 transcript

In most strains of Saccharomyces cerevisiae the mitochondrial gene COX1, for subunit 1 of cytochrome oxidase, contains multiple exons and introns. Processing of COX1 primary transcript requires accessory proteins factors, some of which are encoded by nuclear genes and others by reading frames residing in some of the introns of the COX1 and COB genes. Here we show that the low molecular weight protein product of open reading frame YLR204W, for which we propose the name COX24, is also involved in processing of COX1 RNA intermediates. The growth defect of cox24 mutants is partially rescued in strains harboring mitochondrial DNA lacking introns. Northern blot analyses of mitochondrial transcripts indicate cox24 null mutants to be blocked in processing of introns aI2 and aI3. The dependence of intron aI3 excision on Cox24p is also supported by the growth properties of the cox24 mutant harboring mitochondrial DNA with different intron compositions. The intermediate phenotype of the cox24 mutant in the background of intronless mitochondrial DNA, however, suggests that in addition to its role in splicing of the COX1 pre-mRNA, Cox24p still has another function. Based on the analysis of a cox14-cox24 double mutant, we propose that the other function of Cox24p is related to translation of the COX1 mRNA. © 2006 by The American Society for Biochemistry and Molecular Biology, Inc.