Weekly Trends In ED Admissions: coding framework

Lessons from an undisclosed NHS Trust

I have been busy re-coding 884 different diagnoses in 24 major groupings so we may get a feel for post vaccination roll-out trends. Here are the headings I’ve crunched so far with examples of diseases and conditions to give members some idea of what slides we may get to see as I turn the handle over the next few days. The idea here is to derive raw weekly counts for each grouping for the period Jan - Sep 2021 and then use trend analysis to see whether any series reaches statistical significance; that is to say, that the numbers are going up (or down) beyond that expected by chance. We can then discuss the juiciest of slides knowing that something is going on. I recommend investing in a decent cake and fresh ground coffee - I have no idea what I'll find or what it may mean!

1. Acute Coronary Syndrome (STEMI, NSTEMI, cardiogenic shock, cardiac arrest)

2. Acute respiratory (pneumonia, influenza, respiratory arrest, SARS, COVID-19)

3. Cardiac arrhythmia (fibrillation, tachycardia, bradycardia)

4. Cardiac Conduction (LBBB, AV conduction disorder, RBBB)

5. Cardiac Inflammation (endocarditis, myocarditis, pericarditis)

6. Chronic respiratory (asthma, COPD, tuberculosis)

7. Clotting & embolism (DVT, PE, stroke, embolus, thrombosis)

8. CNS (disorders, seizures, headaches, pain, MS, Parkinsonism, dementia, palsy)

9. Endocrine (diabetes; conditions affecting endocrine glands)

10. General inflammation (cellulitis, bursitis, tonsillitis, panuveitis)

11. GP procedures (wound dressing, certification, sample collection)

12. Gynaecological (miscarriage, menorrhagia, haemorrhage, dysmenorrhoea)

13. Haemorrhage (cerebral haemorrhage, ITP, gastrointestinal bleeding)

14. Heart Failure (cardiomyopathy, LHF, CHF)

15. Hypertension (malignant hypertension, pulmonary hypertension)

16. Infections & infestations (bacterial, viral, parasitic)

17. Major organ (conditions affecting liver & kidney)

18. Null admission (no abnormal findings, patient left)

19. Physical (burns, wounding, fractures, dislocation, sprains, degloving, crushing, contusion, foreign body)

20. Psychiatric (disorders, dementia, anxiolytic dependence, schizophrenia)

21. Rare (Behçet's , Guillain–Barré , Kawasaki, Sjögren's )

22. Self harm (overdose, alcoholism, drug abuse)

23. Sepsis (septic shock, neutropenic sepsis)

24. Social issues (homeless, social problem)