Subtrochanteric Femur Fractures in an Irish Trauma Centre over 9 years: How the Impact of Hospital Coding on Diagnosis of Subtrochanteric Femur Fractures Leads to Inaccurate Occurrence Rates

ABSTRACT

Aim Our aim was to assess the occurrence rates of subtrochanteric femur fractures in an orthopaedic tertiary referral centre and to assess the correlation of patient's actual diagnosis with national hospital inpatient enquiry data. Methods Retrospective data from 2005-2014 was collected from an orthopaedic tertiary referral centre. A revision of all fractures coded subtrochanteric was performed. The plain radiograph images of each case were reviewed by two orthopaedic surgeons and one radiologist, with a reassessment performed of the fracture coding based on the AO/OTA classification system for subtrochanteric fractures. Results One thousand, seven hundred and one patients were admitted to our centre from January 2005 to February 2014 with hip fractures. Using ICD-10 coding, 48 fractures were coded with the diagnosis subtrochanteric femur fractures. Upon application of AO/OTA classification this was revised to 8 cases of subtrochanteric fractures over this period. Discussion Hospital coding of subtrochanteric fractures needs to be accurate to assess this, and all, fractures. Incorrect coding can mislead figures for this type of fracture and give incorrect diagnosis. This study has shown discrepancies between coded data and actual diagnosis. Coding improvements are essential to improve epidemiology studies of subtrochanteric fractures and for accuracy with introduction of activity based funding in to hospitals.