Hospital discharge records as data source to monitor epidemiologic indicators of hematologic malignancies in Abruzzo

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Abstract

Purpose:

To test the feasibility of using hospital discharge records (HDR) to monitor frequency indicators of hematologic malignancies (HM) in Abruzzo, an Italian region without a cancer registry.

Methods:

Hospital discharge records contain a primary diagnosis field for principal disease and 5 secondary diagnosis fields for other diseases related or not to the principal diagnosis. In order to build patient indicators of HM—non-Hodgkin lymphoma (NHL), Hodgkin lymphoma (HL), multiple myeloma (MM), and leukemia (acute lymphoblastic leukemia [ALL], chronic lymphoid leukemia [CLL], acute myeloid leukemia [AML], and chronic myeloid leukemia [CML])—residents with first ICD-9-CM code 200-208 in any HDR field, or only in primary field, were identified.

Results:

Among 3,955 patients with first diagnosis of HM registered in primary or secondary fields of HDR in the 2009-2013 period, and never recognized in 2005-2008 (791/year) (60.5/100,000), patients with first HM only in primary field were 2,304 (461/year) (35.2/100,000): 42% were NHL, 34% leukemia, 16% MM, 8% HL. Patient percentage of 461/791/year (58%) (64% among ordinary HDR and 49% in day-hospital HDR) was 35% for CLL (28/81), 47% for MM (74/152), 50% for CML (16/32), 57% for HL (36/63), 62% for NHL (194/314), and 82% for ALL (18/22) and AML (64/78).

Conclusions:

Applying the cancer registries national rate, expected new diagnoses of HM in Abruzzo are about 620/year (46.4/100,000), compared to HDR estimates of 461 and 791/year (primary/all diagnoses fields: 58%). Since this percentage varies between 35% and 82%, our findings on the 2 methods seem useful for a validation process in the starting Cancer Registry.

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