Olga Endrich

Inselspital, Universitätsspital Bern · Medical Directorat

Background Regarding kidney disease (KD), sex differences in epidemiology and clinical relevance have been reported. Related to absolute and relative changes of baseline creatinine, different criteria for staging may induce underdiagnosis or overdiagnosis related to sex. At the largest Swiss provider of inpatient acute healthcare, a clinic decision...

Hintergrund und Stand der Forschung: SNOMED CT hat sich als Standardnomenklatur im Public Health Kontext etabliert. Zur erfolgreichen Umsetzung der Digitalisierungsstrategie unserer Klinik wird ein Konzept zur Umsetzung von SNOMED CT entwickelt, welches den Aufbau eines Terminology Service, Einführung von Prozess- und Qualitätsmanagement und Annota...

Background and state of research: The Swiss Personalized Health Network (SPHN) is a Swiss national initiative. It contributes to the development of coordinated data infrastructures to make health-relevant data interoperable for research. SPHN developed a framework based on a semantic layer of information and graph technologies for exchange. The SPH...

Background International Classification of Diseases 10th edition (ICD-10) is widely used to describe the burden of disease. Aim To describe how well ICD-10 coding captures sepsis in children admitted to the hospital with blood culture-proven bacterial or fungal infection and systemic inflammatory response syndrome. Methods Secondary analysis of a...

SNOMED CT has an enormous number of clinical concepts and mapping to SNOMED CT is considered as the foundation to achieve semantic interoperability in healthcare. Manual mapping is time-consuming and error-prone thus making this crucial step challenging. In addition, hierarchy retrieval of clinical concepts increases the challenges for the user. Te...

Background Regarding kidney disease, sex differences in epidemiology and clinical relevance have been reported. Related to absolute and relative changes of baseline creatinine, different criteria for staging may induce under- or over-diagnosis related to sex. At the largest Swiss provider of inpatient acute health care, a clinic decision support al...

Background High bed-occupancy (capacity utilization) rates are commonly thought to increase in-hospital mortality; however, little evidence supports a causal relationship between the two. This observational study aimed to assess three time-varying covariates—capacity utilization, patient turnover and clinical complexity level— and to estimate causa...

Objective From January 1, 2018, until July 31, 2020, our hospital network experienced an outbreak of vancomycin-resistant enterococci (VRE). The goal of our study was to improve existing processes by applying machine-learning and graph-theoretical methods to a nosocomial outbreak investigation. Methods We assembled medical records generated during...

SNOMED CT has an enormous number of clinical concepts and mapping to SNOMED CT is considered as the foundation to achieve semantic interoperability in healthcare. Manual mapping is time-consuming and error-prone thus making this crucial step challenging. Terminology Servers provide an interface, which can be used to automate the process of retrievi...

Background There was a nosocomial outbreak of vancomycin-resistant enterococci (VRE) in our hospital from 1.1.2018 to 31.7.2020. The goals of the study were to describe weekly prevalence, and to identify possible effects of the introduction of selected infection control measures. Methods We performed a room centric analysis of 12 floors (243 rooms...

Background: The criteria for the diagnosis of kidney disease outlined in the Kidney Disease: Improving Global Outcomes guidelines are based on a patient's current, historical, and baseline data. The diagnosis of acute kidney injury, chronic kidney disease, and acute-on-chronic kidney disease requires previous measurements of creatinine, back-calcu...

Background Serological tests are a powerful tool in the monitoring of infectious diseases and the detection of host immunity. However, manufacturers often provide diagnostic accuracy data generated through biased studies, and the performance in clinical practice is essentially unclear. Objectives We aimed to determine the diagnostic accuracy of va...

Background There was a nosocomial outbreak of vancomycin-resistant enterococci (VRE) in our hospital group from 2018-19. The goals of the study were to describe the prevalence trajectory and explore risk factors associated with putative room colonization during the outbreak. Methods We performed a room centric analysis of 12 floors (floors F to R,...

Average patient clinical complexity levels by days, days of the week (Monday to Sunday) and weekdays vs weekends over a year for five Swiss general hospital types. https://jmir.org/api/download?alt_name=jmir_v23i8e27163_app3.pdf&filename=7a56aa6ae3a695bb1a7a0e4f6c56797b.pdf

Background: Serological tests are a powerful tool in the monitoring of infectious diseases and the detection of host immunity. However, manufacturers often provide diagnostic accuracy data generated through biased studies and the performance in clinical practice is essentially unclear. Objectives: We aimed to determine the diagnostic accuracy of va...

Background: Variations in hospitals care demand relies not only on the patient’s volume but also on the disease severity. Understanding both daily severity and patients’ volume in hospitals could help to identify pressure zones in hospitals for better hospital capacity planning and policymaking. Objective: This longitudinal study explores daily...

BACKGROUND The criteria for the diagnosis of kidney disease outlined in “The Kidney Disease: Improving Global Outcomes (KDIGO)” are based on a patient’s current, historical and baseline data. The diagnosis of acute (AKI), chronic (CKD) and acute-on-chronic kidney disease requires past measurements of creatinine and back-calculation and the interpre...

Background: Worldwide, hospitals face pressure to reduce costs. Some respond by working with a reduced number of nurses or less qualified nursing staff. Objective: This study aims at examining the relationship between mortality and patient exposure to shifts with low or high nurse staffing. Methods: This longitudinal study used routine shift-, un...

BACKGROUND Variations in hospitals’ care demand relies not only on the patient volume but also on the disease severity. Understanding both daily severity and patient volume in hospitals could help to identify hospital pressure zones to improve hospital-capacity planning and policy-making. OBJECTIVE This longitudinal study explored daily care deman...

Background Understanding how comorbidity measures contribute to patient mortality is essential both to describe patient health status and to adjust for risks and potential confounding. The Charlson and Elixhauser comorbidity indices are well-established for risk adjustment and mortality prediction. Still, a different set of comorbidity weights migh...

Background With an increasing rate of caesarean sections as well as rising numbers of multiple pregnancies, valid classifications for benchmarking are needed. The Robson classification provides a method to group cases with caesarean section in order to assess differences in outcome across regions and sites. In this study we set up a novel method of...

«Nil novi sub sole» – so könnte man meinen. Nur wenige neue Marker haben in den letzten Jahren den Weg in die Nierendiagnostik gefunden, und das Creatinin bleibt einer der am häufigsten ange- forderten Analyten. Doch die Disruption kommt: digital und in Ergänzung zu bestehender Diagnostik. Klinische Daten bringen in Verbindung mit altbekannter und...

The recent resolution on sepsis by the World Health Organization urges member states to better characterize the burden of sepsis. Sepsis coding based on the International Statistical Classification of Diseases and Related Health Problems (ICD-10) is widely used, however, there is a lack of paediatric data assessing accuracy of ICD-10 sepsis coding....

Background When chronic conditions are associated with outcomes such as mortality, comorbidity measures are essential both to describe patient health status and to adjust for potential confounding. The Charlson and Elixhauser comorbidity indices are well-established for risk adjustment and mortality prediction. Still, as optimal comorbidity weighti...

Background: Understanding how comorbidity measures contribute to patient mortality are essential both to describe patient health status and to adjust for risks and potential confounding. The Charlson and Elixhauser comorbidity indices are well-established for risk adjustment and mortality prediction. Still, a different set of comorbidity weights mi...

Background: Understanding how comorbidity measures contribute to patient mortality is essential both to describe patient health status and to adjust for risks and potential confounding. The Charlson and Elixhauser comorbidity indices are well-established for risk adjustment and mortality prediction. Still, a different set of comorbidity weights mig...

Background: Understanding how comorbidity measures contribute to patient mortality is essential both to describe patient health status and to adjust for risks and potential confounding. The Charlson and Elixhauser comorbidity indices are well-established for risk adjustment and mortality prediction. Still, a different set of comorbidity weights mig...

Background: Variations in patient demand increase the challenge of balancing high-quality nursing skill mixes against budgetary constraints. Developing staffing guidelines that will allow high quality care at minimal cost requires first exploring the dynamic changes in nursing workload over the course of a day. Objective: Accordingly, this longi...

With this study it could be demonstrated, that a complex query on routinely collected health data could serve for medical classification, benchmarking and monitoring of quality and outcome. The Robson classification has the capacity to improve international comparability, national benchmarking. With rising numbers in CS (elective and emergency), r...

Reflecting the trend of the demographic change, the population of inpatients is getting older on average. Rising age does not necessarily imply adverse outcome. The question, if age categories can be associated to hospitalization outcome and which categories can be defined, is not answered yet. The objective of our study is to develop a method to d...

“neither fetal size nor weight can be regarded as sure indications of fetal age” Ballantyne JW. THE PROBLEM OF THE PREMATURE INFANT. BMJ [Internet] 1902 [cited 2019 Jun 12];1:1196–200. Available from: http://www.bmj.com/cgi/doi/10.1136/bmj.1.2159.1196

Although the complexity and length of treatment is connected to the newborn’s maturity and birth weight, most case-mix grouping schemes classify newborns by birth weight alone. The objective of this study was to determine whether the definition of thresholds based on a changepoint analysis of variability of birth weight and gestational age contribu...

Background: “The Kidney Disease: Improving Global Outcomes (KDIGO)” criteria for diagnosis and classification of kidney disease are based on a patient’s current and historical values and on baseline data. For the diagnosis of acute (AKI), chronic (CKI) and acute on chronic kidney injury historic measurements of creatinine and back calculation might...

Background: With an increasing rate of caesarean sections (CS) as well as rising numbers of multiple pregnancies, valid classifications are needed. Benchmarking with regard to the CS rate and outcome is only possible, if a commonly accepted classification is established. The Robson classification provides a valid method to group cases with CS. Res...

Figures and data for Abstract of the 27th European Workshop on Neonatology Rotterdam, The Netherlands, September 1-3, 2019; Changepoint analysis of gestational age and birthweight – Verifying a refinement of Diagnosis Related (DRG) Groups by monochorial and dichorial twins; Journal of Neonatal-Perinatal Medicine 12 (2019) 351–364 DOI:10.3233/NPM-19...

A novel method of classification of newborn cases by changepoint analysis was developed, providing the possibility to assign costs or outcome indicators to grouping mechanisms by gestational age and birthweight combined. The application to the different groups of twins suggests a usability also in the clinical context and other parameters.

The abstract won the Informatic Division’s first price at the 71st AACC Annual Scientific Meeting & Clinical Lab Expo in Anaheim, CA, 8/2019 and was presented by Olga Endrich at the Informatics Division ePoster Session.

BACKGROUND Variations in patient demand increase the challenge of balancing high-quality nursing skill mixes against budgetary constraints. Developing staffing guidelines that will allow high quality care at minimal cost requires first exploring the dynamic changes in nursing workload over the course of a day. OBJECTIVE Accordingly, this longitudi...

Disease-related malnutrition (DRM) is a highly prevalent independent risk and cost factor with significant influence on mortality, morbidity, length of hospital stay (LOS), functional impairment and quality of life. The aim of our research was to estimate the economic impact of the introduction of routinely performed nutritional screening (NS) in a...

Category 2 Presentation A Accuracy of ICD-10 coding for sepsis and organ dysfunctions in children with blood culture-proven sepsis in Switzerland, results from the prospective Swiss Pediatric Sepsis Study

Führt das Gestationsalter als Variable in der Gruppierung zu kostenhomogeneren Gruppen als die des Geburtsgewichtes? Changepoint Analyse zur Bildung homogener Gruppen und Vorschlag einer anwendungsorientierten Gruppierungsmatrix.

Mit abnehmender Reife eines Neugeborenen resultiert ein höherer Behandlungsaufwand und entsprechende Fallkosten. Gestationsalter (GA) und Geburtsgewicht (BW) korrelieren zum Behandlungsaufwand. Verschiedene nationale Gesundheitssysteme rechnen stationäre Fälle über Diagnosis Related Groups (DRG) ab, welche die Variable BW dominant für die Bewertung...

Induction chemotherapy in AML patients may have life-threatening side effects requiring intensive care unit (ICU) treatment. We analyzed all AML patients receiving intensive chemotherapy at a single academic center between 01/2006-12/2016. At least one ICU admission was observed in 32% (76/240) patients, and 33% of those died following ICU admissio...

Evaluation SwissDRG reimbursement and homogeneity of case related costs, variables birth weight and gestational age evaluated

GESTATIONAL AGE VERSUS BIRTH WEIGHT – EVALUATING RESOURCE CONSUMPTION UND REIMBURSEMENT IN NEONATAL MEDICINE AT A SWISS TERTIARY CARE CENTER USING ROUTINELY COLLECTED HEALTH DATA FROM 2016 – 2017

Background With few exceptions the International Statistical Classification of Diseases (ICD) codes for diagnoses and official coding guidelines do not distinguish pre-existing conditions from complications or comorbidities which occur during hospitalization. However, information on diagnosis timing is relevant with regard to the case’s severity, r...

Zusammenfassung Hintergrund Die krankheitsassoziierte Mangelernährung (KAM) ist in Krankenhäusern ein häufiges Problem mit medizinischen und ökonomischen Folgen. Die vorliegende Vier-Jahres-Analyse soll zeigen, ob die Aufwände für die Ernährungstherapien der mangelernährten Patienten durch den Mehrertrag, der durch die Kodierung der KAM im SwissDRG...

Asphyxia in the Newborn: Evaluating the Accuracy of ICD Coding, Clinical Diagnosis and Reimbursement: Observational Study at a Swiss Tertiary Care Center on Routinely Collected Health Data from 2012-2015 Olga Endrich1*, Carole Rimle2, Marcel Zwahlen3, Karen Triep1, Luigi Raio4, Mathias Nelle5 1 Medical Directorate, Inselspital, University Hospital...

Background The ICD-10 categories of the diagnosis “perinatal asphyxia” are defined by clinical signs and a 1-minute Apgar score value. However, the modern conception is more complex and considers metabolic values related to the clinical state. A lack of consistency between the former clinical and the latter encoded diagnosis poses questions over th...

Plot “Original Coding”. (TIFF)

Plot “Coding.KHB”. (TIFF)

Number of live births in Switzerland in 2004–2014. (DOCX)

Raw data underlying the findings. (XLSX)

Coding Guidelines 2016. (TIFF)

Plot “Matrix”. (TIFF)

Number of Diagnoses P20*, P21*, P91* coded in Switzerland for 2004–2014. (DOCX)

Biochemical Values Cases. (DOCX)

Earning SwissDRG billing Year. (DOCX)

CHOP Codes which indicated a mechanical ventilation, a systemic hypothermia and significant OR procedure. (DOCX)

Background: Cardiovascular diseases are the leading cause of death worldwide and in Switzerland. When applied, treatment guidelines for patients with acute ST-segment elevation myocardial infarction (STEMI) improve the clinical outcome and should eliminate treatment differences by sex and age for patients whose clinical situations are identical. I...

Results of the multilevel Poisson regression for revascularization. (DOCX)

Results of the multilevel Poisson regression for revascularization for male and female patients younger than 65 years. (DOCX)

Predefined main diagnosis at first hospitalization record if second hospitalization record is STEMI. (DOCX)

CHOP and APDRG codes used to identify PCI treatment. (DOCX)

CHOP and APDRG codes used to identify CABG treatment. (DOCX)

Results of the multilevel Poisson regression for revascularization for male and female patients 65 years and older. (DOCX)