Simplified calculation of month-on-month annualized peritoneal dialysis associated peritonitis rate – Validation in ANZDATA, NZ PD and RDPLF registries

M. Marshall, Gerald P Waters, C. Verger
{"title":"Simplified calculation of month-on-month annualized peritoneal dialysis associated peritonitis rate – Validation in ANZDATA, NZ PD and RDPLF registries","authors":"M. Marshall, Gerald P Waters, C. Verger","doi":"10.25796/bdd.v5i3.67753","DOIUrl":null,"url":null,"abstract":"Peritonitis is the most important therapy-related complication of peritoneal dialysis (PD). Monthly or quarterly PD peritonitis rate statistics are used to identify special cause variation within or between individual PD centres, to highlight any need for quality improvement. Unfortunately, many PD centres do not accurately “patient flow” (i.e., when patients start and finish on PD), and therefore cannot measure PD peritonitis rate. In this study, we validate an estimating formula for month-on-month annualised PD peritonitis rate, that calculates time-at-risk from “patient stock” (i.e., the number of prevalent patients on PD at the beginning and end of the month). We compared centers’ estimated peritonitis rates with gold-standard measurements in the Australia and New Zealand Dialysis and Transplant Registry / New Zealand PD Registry, and Le Registre de Dialyse Péritonéale de Langue Française et hémodialyse à domicile. A total of 268 centers from 9 countries with 1,020,260 patient-months of follow-up and 19,669 episodes of peritonitis were modeled. Overall agreement was excellent between estimates and gold-standard measurements with a concordance correlation coefficient (CCC) of 0.998 (95% confidence interval [CI] 0.998-0.998) in both registries. There was statistically significant lower agreement for smaller centers, although the CCC was still greater than 0.995. There were no instances of clinically significant misclassification of centers as being compliant or non-compliant with PD peritonitis standards with the use of the estimating formula. The simplified method of calculating the PD peritonitis rate is accurate and will allow more centers around the world to measure, report, and work on reducing PD peritonitis rates.","PeriodicalId":366938,"journal":{"name":"Bulletin de la Dialyse à Domicile","volume":"1 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Bulletin de la Dialyse à Domicile","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.25796/bdd.v5i3.67753","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1

Abstract

Peritonitis is the most important therapy-related complication of peritoneal dialysis (PD). Monthly or quarterly PD peritonitis rate statistics are used to identify special cause variation within or between individual PD centres, to highlight any need for quality improvement. Unfortunately, many PD centres do not accurately “patient flow” (i.e., when patients start and finish on PD), and therefore cannot measure PD peritonitis rate. In this study, we validate an estimating formula for month-on-month annualised PD peritonitis rate, that calculates time-at-risk from “patient stock” (i.e., the number of prevalent patients on PD at the beginning and end of the month). We compared centers’ estimated peritonitis rates with gold-standard measurements in the Australia and New Zealand Dialysis and Transplant Registry / New Zealand PD Registry, and Le Registre de Dialyse Péritonéale de Langue Française et hémodialyse à domicile. A total of 268 centers from 9 countries with 1,020,260 patient-months of follow-up and 19,669 episodes of peritonitis were modeled. Overall agreement was excellent between estimates and gold-standard measurements with a concordance correlation coefficient (CCC) of 0.998 (95% confidence interval [CI] 0.998-0.998) in both registries. There was statistically significant lower agreement for smaller centers, although the CCC was still greater than 0.995. There were no instances of clinically significant misclassification of centers as being compliant or non-compliant with PD peritonitis standards with the use of the estimating formula. The simplified method of calculating the PD peritonitis rate is accurate and will allow more centers around the world to measure, report, and work on reducing PD peritonitis rates.
简化计算每月腹膜透析相关腹膜炎的年化率- ANZDATA, NZ PD和RDPLF注册验证
腹膜炎是腹膜透析(PD)最重要的治疗相关并发症。每月或每季度的腹膜炎发生率统计数据用于确定个别腹膜炎中心内部或之间的特殊原因差异,以突出质量改进的任何需要。不幸的是,许多PD中心没有准确的“患者流量”(即患者开始和结束PD治疗的时间),因此无法测量PD腹膜炎的发生率。在这项研究中,我们验证了一个月环比年度PD腹膜炎率的估计公式,该公式计算了“患者库存”(即每月初和月末PD流行患者的数量)的风险时间。我们将各中心估计的腹膜炎率与澳大利亚和新西兰透析和移植登记处/新西兰PD登记处的金标准测量值进行了比较,并将Le register de Dialyse p法国语言和 住所。共有来自9个国家的268个中心,随访1020260例患者,随访19669例腹膜炎。在两个注册表中,估计值与金标准测量值之间的总体一致性非常好,一致性相关系数(CCC)为0.998(95%可信区间[CI] 0.998-0.998)。尽管CCC仍大于0.995,但较小中心的一致性在统计学上显著降低。在使用估算公式时,没有临床显著的中心符合或不符合PD腹膜炎标准的错误分类实例。计算PD腹膜炎率的简化方法是准确的,将允许世界上更多的中心测量,报告和减少PD腹膜炎率的工作。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信