637Validation of anaemia, haemorrhage and blood disorder reporting in routinely collected hospital data

Abstract

Abstract Background Blood and bleeding related conditions are reported in hospital administrative data, however the reliability of these data is unknown. Here we examine the reliability of reporting of conditions including anaemia, obstetric haemorrhage and blood disorders, and procedures, such as transfusion and hysterectomy, in hospital records compared with obstetric databases. Methods Women giving birth to singleton infants in two tertiary hospitals in New South Wales, Australia, between 2011 and 2015 were included. Reporting in the hospital data, drawn from the Electronic Medical Records, was compared to that in linked obstetric data, obtained from the ObstetriX system, using obstetric data as the gold standard. Results 36,051 births were included. Sensitivity for anaemia and blood disorders was low (2.5–24.8%, positive predictive value (PPV) 12.0–82.6%), high for postpartum haemorrhage, transfusion and hysterectomy (82.8–96.0%, PPV 78.0–89.6%), and moderate for other obstetric haemorrhage (sensitivity: 41.9–65.1%, PPV: 50.0–56.8%) and placental complications (sensitivity 68.2–81.3%, PPV: 20.3–72.3%). Specificity and negative predictive values were high. Conclusions Anaemia and blood disorders are poorly reported in hospital data. Postpartum haemorrhage, transfusion and hysterectomy are well reported, while other obstetric haemorrhage and placental complications are moderately well reported. Key messages Hospital data may be a reliable source of information on postpartum haemorrhage, blood transfusion and hysterectomy. Caution is advised in the use of hospital data for studies of anaemia and blood disorders, and other sources should be sought where possible.