{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:03:03Z","timestamp":1787025783888,"version":"build-2736575974"},"reference-count":52,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Obstetric brachial plexus injury (OBPI) is a serious and complex nerve injury in newborns. To date, large-scale studies and guidelines for managing OBPI are scarce, and there are major regional differences in its epidemiology and clinical management. The authors of this national cohort study aimed to report on OBPI\u2019s current epidemiology and surgical management strategies in Germany.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n Patients hospitalized in Germany between January 1, 2005, and December 31, 2018, with OBPI as their primary diagnosis were identified using the ICD-10 codes P14.0 (Erb palsy), P14.1 (Klumpke palsy), and P14.3 (other brachial plexus birth injuries). Operation and Procedure Classification System codes were used to allow analysis of surgical management.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n A total of 2069 patients with OBPI who had been hospitalized within their 1st year of life were included in the study. Erb palsy was the most frequent OBPI subtype (66.60%). The total number of live births increased significantly from 685,795 in 2005 to 787,523 in 2018 (p < 0.001), resulting in an overall OBPI rate of 0.21 per 1000 births over the years. The incidence of OBPI per 1000 live births significantly decreased by 47.57%, from 0.28 in 2005 to 0.15 in 2018 (p < 0.001), representing a mean annual decrease of 0.010 \u00b1 0.026. Subgroup analysis also showed a significant (p < 0.001) decrease in all three OBPI subtypes (ICD-10 codes P14.0, P14.1, and P14.3). Simultaneously, the rates of cesarean delivery significantly varied, ranging from 26.73% to 28.08% from 2005 to 2018 (p < 0.001).<\/jats:p>\n The most frequent risk factor for OBPI was being large for gestational age (13.83%), followed by instrumental delivery or cephalohematoma (6.30%). Total rates of surgical management ranged from 1.86% to 41.11% and had an increasing proportional trend over time (p = 0.002). Subanalysis of the different surgical treatment modalities demonstrated an increasing trend in surgical explorations and neurolyses (p = 0.001).<\/jats:p>\n Length of hospital stay among patients treated for OBPI remained relatively constant throughout the study period with a mean range of 3.57\u20134.93 days, indicating no significant change (p = 0.52).<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n OBPI is a rare disease, with a decreasing incidence paralleled by an increase in cesarean birth delivery rates between 2005 and 2018 in Germany. Total surgical management rates rose with a significant trend toward increasing microsurgical explorations and neurolyses. Being large for gestational age was identified as the main infantile risk factor for OBPI.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2025.1.peds24626","type":"journal-article","created":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T22:44:09Z","timestamp":1746225849000},"page":"119-126","source":"Crossref","is-referenced-by-count":2,"title":["Epidemiology and surgical management of obstetric brachial plexus injury: a national cohort study"],"prefix":"10.3171","volume":"36","author":[{"given":"Tarik Alp","family":"Sargut","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Medical Faculty and University Hospital D\u00fcsseldorf, Heinrich-Heine-University D\u00fcsseldorf;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiarash","family":"Ferdowssian","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina Susanne","family":"Mark-Sargut","sequence":"additional","affiliation":[{"name":"Anesthesiology and Intensive Care Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D\u00f6rte","family":"Huscher","sequence":"additional","affiliation":[{"name":"Institute of Biometry and Clinical Epidemiology, Charit\u00e9 - Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt Universit\u00e4t zu Berlin;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Alsolivany","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton","family":"Fr\u00fch","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Bahm","sequence":"additional","affiliation":[{"name":"Section for Plexus Surgery, Clinic for Plastic, Hand and Burns Surgery, University Hospital Aachen;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich-Wilhelm","family":"Thomale","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Department of Neurosurgery, Charit\u00e9 - Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt Universit\u00e4t zu Berlin;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nora F.","family":"Dengler","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, HELIOS Hospital Bad Saarow; and"},{"name":"Faculty of Health Sciences, Brandenburg Medical School Theodor Fontane, Potsdam, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"Indian J Plast Surg","first-page":"380","article-title":"Obstetric brachial plexus injury","volume":"44","author":"Thatte MR","year":"2011","unstructured":"Thatte MR, Mehta R. Obstetric brachial plexus injury. Indian J Plast Surg. 2011;44(3):380\u2013389."},{"issue":"2","key":"b2","series-title":"Dev Med Child Neurol","first-page":"138","article-title":"Natural history of obstetric brachial plexus palsy: a systematic review","volume":"46","author":"Pondaag W","year":"2004","unstructured":"Pondaag W, Malessy MJA, van Dijk JG, Thomeer RTW. Natural history of obstetric brachial plexus palsy: a systematic review. Dev Med Child Neurol. 2004;46(2):138\u2013144."},{"issue":"6","key":"b3","series-title":"J Bone Joint Surg Am","first-page":"1258","article-title":"The epidemiology of neonatal brachial plexus palsy in the United States","volume":"90","author":"Foad SL","year":"2008","unstructured":"Foad SL, Mehlman CT, Ying J. The epidemiology of neonatal brachial plexus palsy in the United States. J Bone Joint Surg Am. 2008;90(6):1258\u20131264."},{"issue":"4","key":"b4","series-title":"Microsurgery","first-page":"334","article-title":"Long-term results of primary repair of brachial plexus lesions in children","volume":"26","author":"Gilbert A","year":"2006","unstructured":"Gilbert A, Pivato G, Kheiralla T. Long-term results of primary repair of brachial plexus lesions in children. Microsurgery. 2006;26(4):334\u2013342."},{"issue":"4","key":"b5","series-title":"Obstet Gynecol","first-page":"536","article-title":"Associated factors in 1611 cases of brachial plexus injury","volume":"93","author":"Gilbert WM","year":"1999","unstructured":"Gilbert WM, Nesbitt TS, Danielsen B. Associated factors in 1611 cases of brachial plexus injury. Obstet Gynecol. 1999;93(4):536\u2013540."},{"issue":"10-11","key":"b6","series-title":"Childs Nerv Syst","first-page":"638","article-title":"Management of obstetric brachial plexus lesions: state of the art and future developments","volume":"16","author":"van Ouwerkerk WJR","year":"2000","unstructured":"van Ouwerkerk WJR, van der Sluijs JA, Nollet F, Barkhof F, Slooff ACJ. Management of obstetric brachial plexus lesions: state of the art and future developments. Childs Nerv Syst. 2000;16(10-11):638\u2013644."},{"issue":"8","key":"b7","series-title":"J Hand Surg Eur","first-page":"798","article-title":"C5-8 neonatal brachial plexus palsy. Operative findings, reconstructive strategy and outcome","volume":"45","author":"Lombard A","year":"2020","unstructured":"Lombard A, Bachy M, Fitoussi F. C5-8 neonatal brachial plexus palsy. Operative findings, reconstructive strategy and outcome. J Hand Surg Eur Vol. 2020;45(8):798-804."},{"issue":"4","key":"b8","series-title":"J Bone Joint Surg Br","first-page":"571","article-title":"Obstetric traction injuries of the brachial plexus. Natural history, indications for surgical repair and results","volume":"70","author":"Boome RS","year":"1988","unstructured":"Boome RS, Kaye JC. Obstetric traction injuries of the brachial plexus. Natural history, indications for surgical repair and results. J Bone Joint Surg Br. 1988;70(4):571\u2013576."},{"issue":"2","key":"b9","series-title":"Paediatr Child Health","first-page":"93","article-title":"Perinatal brachial plexus palsy","volume":"11","author":"Andersen J","year":"2006","unstructured":"Andersen J, Watt J, Olson J, Van Aerde J. Perinatal brachial plexus palsy. Paediatr Child Health. 2006;11(2):93\u2013100."},{"issue":"1","key":"b10","series-title":"J Pediatr Orthop","first-page":"116","article-title":"Update on management of pediatric brachial plexus palsy","volume":"25","author":"Waters PM","year":"2005","unstructured":"Waters PM. Update on management of pediatric brachial plexus palsy. J Pediatr Orthop. 2005;25(1):116\u2013126."},{"issue":"1 suppl","key":"b11","series-title":"J Neurosurg","first-page":"33","article-title":"Recovery of hand function following nerve grafting and transfer in obstetric brachial plexus lesions","volume":"105","author":"Pondaag W","year":"2006","unstructured":"Pondaag W, Malessy MJA. Recovery of hand function following nerve grafting and transfer in obstetric brachial plexus lesions. J Neurosurg. 2006;105(1 suppl):33\u201340."},{"issue":"1","key":"b12","series-title":"ISRN Pediatr","first-page":"307039","article-title":"Risk factors at birth for permanent obstetric brachial plexus injury and associated osseous deformities","volume":"2012","author":"Nath RK","year":"2012","unstructured":"Nath RK, Kumar N, Avila MB, Risk factors at birth for permanent obstetric brachial plexus injury and associated osseous deformities. ISRN Pediatr. 2012;2012(1):307039."},{"issue":"6","key":"b13","series-title":"J Hand Surg Am","first-page":"515.e1","article-title":"Assessment of current epidemiology and risk factors surrounding brachial plexus birth palsy","volume":"44","author":"Abzug JM","year":"2019","unstructured":"Abzug JM, Mehlman CT, Ying J. Assessment of current epidemiology and risk factors surrounding brachial plexus birth palsy. J Hand Surg Am. 2019;44(6):515.e1\u2013515.e10."},{"issue":"2","key":"b14","series-title":"J Pediatr Orthop","first-page":"e134","article-title":"The epidemiology of brachial plexus birth palsy in the United States: declining incidence and evolving risk factors","volume":"39","author":"DeFrancesco CJ","year":"2019","unstructured":"DeFrancesco CJ, Shah DK, Rogers BH, Shah AS. The epidemiology of brachial plexus birth palsy in the United States: declining incidence and evolving risk factors. J Pediatr Orthop. 2019;39(2):e134\u2013e140."},{"issue":"2","key":"b15","series-title":"Article in German. Gesundheitswesen","first-page":"120","article-title":"Good Practice of Secondary Data Analysis (GPS): guidelines and recommendations","volume":"77","author":"Swart E","year":"2015","unstructured":"Swart E, Gothe H, Geyer S, Good Practice of Secondary Data Analysis (GPS): guidelines and recommendations. Article in German. Gesundheitswesen. 2015;77(2):120\u2013126."},{"issue":"3","key":"b16","series-title":"Obstet Gynecol Surv","first-page":"183","article-title":"Recurrent shoulder dystocia: a review","volume":"65","author":"Bingham J","year":"2010","unstructured":"Bingham J, Chauhan SP, Hayes E, Gherman R, Lewis D. Recurrent shoulder dystocia: a review. Obstet Gynecol Surv. 2010;65(3):183\u2013188."},{"issue":"6","key":"b17","series-title":"Dev Med Child Neurol","first-page":"673","article-title":"Risk factors for neonatal brachial plexus palsy: a systematic review and meta-analysis","volume":"62","author":"Van der Looven R","year":"2020","unstructured":"Van der Looven R, Le Roy L, Tanghe E, Risk factors for neonatal brachial plexus palsy: a systematic review and meta-analysis. Dev Med Child Neurol. 2020;62(6):673\u2013683."},{"issue":"4","key":"b18","series-title":"Semin Perinatol","first-page":"210","article-title":"Neonatal brachial plexus palsy: incidence, prevalence, and temporal trends","volume":"38","author":"Chauhan SP","year":"2014","unstructured":"Chauhan SP, Blackwell SB, Ananth CV. Neonatal brachial plexus palsy: incidence, prevalence, and temporal trends. Semin Perinatol. 2014;38(4):210\u2013218."},{"issue":"1","key":"b19","series-title":"Acta Obstet Gynecol Scand","first-page":"76","article-title":"Increased incidence of shoulder dystocia but a declining incidence of obstetric brachial plexus palsy in vaginally delivered infants","volume":"102","author":"Mollberg M","year":"2023","unstructured":"Mollberg M, Ladfors LV, Str\u00f6mbeck C, Elden H, Ladfors L. Increased incidence of shoulder dystocia but a declining incidence of obstetric brachial plexus palsy in vaginally delivered infants. Acta Obstet Gynecol Scand. 2023;102(1):76\u201381."},{"issue":"1","key":"b20","series-title":"Obstet Gynecol","first-page":"14","article-title":"Improving neonatal outcome through practical shoulder dystocia training","volume":"112","author":"Draycott TJ","year":"2008","unstructured":"Draycott TJ, Crofts JF, Ash JP, Improving neonatal outcome through practical shoulder dystocia training. Obstet Gynecol. 2008;112(1):14\u201320."},{"issue":"4","key":"b21","series-title":"Am J Obstet Gynecol","first-page":"322.e1","article-title":"Effects of shoulder dystocia training on the incidence of brachial plexus injury","volume":"204","author":"Inglis SR","year":"2011","unstructured":"Inglis SR, Feier N, Chetiyaar JB, Effects of shoulder dystocia training on the incidence of brachial plexus injury. Am J Obstet Gynecol. 2011;204(4):322.e1\u2013322.e6."},{"issue":"12","key":"b22","series-title":"Eur J Clin Nutr","first-page":"1757","article-title":"Obesity in pregnant women: a 20-year analysis of the German experience","volume":"75","author":"Strauss A","year":"2021","unstructured":"Strauss A, Rochow N, Kunze M, Hesse V, Dudenhausen JW, Voigt M. Obesity in pregnant women: a 20-year analysis of the German experience. Eur J Clin Nutr. 2021;75(12):1757\u20131763."},{"issue":"10","key":"b23","series-title":"PLoS One","first-page":"e0276406","article-title":"Fetal malposition in labour and health outcomes for women and their newborn infants: a retrospective cohort study","volume":"17","author":"Barrowclough J","year":"2022","unstructured":"Barrowclough J, Kool B, Crowther C. Fetal malposition in labour and health outcomes for women and their newborn infants: a retrospective cohort study. PLoS One. 2022;17(10):e0276406."},{"issue":"9","key":"b24","series-title":"J Matern Fetal Neonatal Med","first-page":"563","article-title":"Associated factors and outcomes of persistent occiput posterior position: a retrospective cohort study from 1976 to 2001","volume":"19","author":"Cheng YW","year":"2006","unstructured":"Cheng YW, Shaffer BL, Caughey AB. Associated factors and outcomes of persistent occiput posterior position: a retrospective cohort study from 1976 to 2001. J Matern Fetal Neonatal Med. 2006;19(9):563\u2013568."},{"issue":"4","key":"b25","series-title":"Ultrasound Obstet Gynecol","first-page":"425","article-title":"Investigation of occiput posterior delivery by intrapartum sonography","volume":"24","author":"Akmal S","year":"2004","unstructured":"Akmal S, Tsoi E, Howard R, Osei E, Nicolaides KH. Investigation of occiput posterior delivery by intrapartum sonography. Ultrasound Obstet Gynecol. 2004;24(4):425\u2013428."},{"issue":"3","key":"b26","series-title":"Br J Surg","first-page":"236","article-title":"Accuracy of surgical complication rate estimation using ICD-10 codes","volume":"106","author":"Storesund A","year":"2019","unstructured":"Storesund A, Haugen AS, Hjort\u00e5s M, Accuracy of surgical complication rate estimation using ICD-10 codes. Br J Surg. 2019;106(3):236\u2013244."},{"issue":"3","key":"b1","series-title":"Indian J Plast Surg","first-page":"380","article-title":"Obstetric brachial plexus injury","volume":"44","author":"Thatte MR","year":"2011","unstructured":"Thatte MR, Mehta R. Obstetric brachial plexus injury. Indian J Plast Surg. 2011;44(3):380\u2013389."},{"issue":"2","key":"b2","series-title":"Dev Med Child Neurol","first-page":"138","article-title":"Natural history of obstetric brachial plexus palsy: a systematic review","volume":"46","author":"Pondaag W","year":"2004","unstructured":"Pondaag W, Malessy MJA, van Dijk JG, Thomeer RTW. Natural history of obstetric brachial plexus palsy: a systematic review. Dev Med Child Neurol. 2004;46(2):138\u2013144."},{"issue":"6","key":"b3","series-title":"J Bone Joint Surg Am","first-page":"1258","article-title":"The epidemiology of neonatal brachial plexus palsy in the United States","volume":"90","author":"Foad SL","year":"2008","unstructured":"Foad SL, Mehlman CT, Ying J. The epidemiology of neonatal brachial plexus palsy in the United States. J Bone Joint Surg Am. 2008;90(6):1258\u20131264."},{"issue":"4","key":"b4","series-title":"Microsurgery","first-page":"334","article-title":"Long-term results of primary repair of brachial plexus lesions in children","volume":"26","author":"Gilbert A","year":"2006","unstructured":"Gilbert A, Pivato G, Kheiralla T. Long-term results of primary repair of brachial plexus lesions in children. Microsurgery. 2006;26(4):334\u2013342."},{"issue":"4","key":"b5","series-title":"Obstet Gynecol","first-page":"536","article-title":"Associated factors in 1611 cases of brachial plexus injury","volume":"93","author":"Gilbert WM","year":"1999","unstructured":"Gilbert WM, Nesbitt TS, Danielsen B. Associated factors in 1611 cases of brachial plexus injury. 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J Hand Surg Eur Vol. 2020;45(8):798-804."},{"issue":"4","key":"b8","series-title":"J Bone Joint Surg Br","first-page":"571","article-title":"Obstetric traction injuries of the brachial plexus. Natural history, indications for surgical repair and results","volume":"70","author":"Boome RS","year":"1988","unstructured":"Boome RS, Kaye JC. Obstetric traction injuries of the brachial plexus. Natural history, indications for surgical repair and results. J Bone Joint Surg Br. 1988;70(4):571\u2013576."},{"issue":"2","key":"b9","series-title":"Paediatr Child Health","first-page":"93","article-title":"Perinatal brachial plexus palsy","volume":"11","author":"Andersen J","year":"2006","unstructured":"Andersen J, Watt J, Olson J, Van Aerde J. Perinatal brachial plexus palsy. 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J Neurosurg. 2006;105(1 suppl):33\u201340."},{"issue":"1","key":"b12","series-title":"ISRN Pediatr","first-page":"307039","article-title":"Risk factors at birth for permanent obstetric brachial plexus injury and associated osseous deformities","volume":"2012","author":"Nath RK","year":"2012","unstructured":"Nath RK, Kumar N, Avila MB, Risk factors at birth for permanent obstetric brachial plexus injury and associated osseous deformities. ISRN Pediatr. 2012;2012(1):307039."},{"issue":"6","key":"b13","series-title":"J Hand Surg Am","first-page":"515.e1","article-title":"Assessment of current epidemiology and risk factors surrounding brachial plexus birth palsy","volume":"44","author":"Abzug JM","year":"2019","unstructured":"Abzug JM, Mehlman CT, Ying J. Assessment of current epidemiology and risk factors surrounding brachial plexus birth palsy. J Hand Surg Am. 2019;44(6):515.e1\u2013515.e10."},{"issue":"2","key":"b14","series-title":"J Pediatr Orthop","first-page":"e134","article-title":"The epidemiology of brachial plexus birth palsy in the United States: declining incidence and evolving risk factors","volume":"39","author":"DeFrancesco CJ","year":"2019","unstructured":"DeFrancesco CJ, Shah DK, Rogers BH, Shah AS. The epidemiology of brachial plexus birth palsy in the United States: declining incidence and evolving risk factors. J Pediatr Orthop. 2019;39(2):e134\u2013e140."},{"issue":"2","key":"b15","series-title":"Article in German. Gesundheitswesen","first-page":"120","article-title":"Good Practice of Secondary Data Analysis (GPS): guidelines and recommendations","volume":"77","author":"Swart E","year":"2015","unstructured":"Swart E, Gothe H, Geyer S, Good Practice of Secondary Data Analysis (GPS): guidelines and recommendations. Article in German. 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Dev Med Child Neurol. 2020;62(6):673\u2013683."},{"issue":"4","key":"b18","series-title":"Semin Perinatol","first-page":"210","article-title":"Neonatal brachial plexus palsy: incidence, prevalence, and temporal trends","volume":"38","author":"Chauhan SP","year":"2014","unstructured":"Chauhan SP, Blackwell SB, Ananth CV. Neonatal brachial plexus palsy: incidence, prevalence, and temporal trends. Semin Perinatol. 2014;38(4):210\u2013218."},{"issue":"1","key":"b19","series-title":"Acta Obstet Gynecol Scand","first-page":"76","article-title":"Increased incidence of shoulder dystocia but a declining incidence of obstetric brachial plexus palsy in vaginally delivered infants","volume":"102","author":"Mollberg M","year":"2023","unstructured":"Mollberg M, Ladfors LV, Str\u00f6mbeck C, Elden H, Ladfors L. Increased incidence of shoulder dystocia but a declining incidence of obstetric brachial plexus palsy in vaginally delivered infants. Acta Obstet Gynecol Scand. 2023;102(1):76\u201381."},{"issue":"1","key":"b20","series-title":"Obstet Gynecol","first-page":"14","article-title":"Improving neonatal outcome through practical shoulder dystocia training","volume":"112","author":"Draycott TJ","year":"2008","unstructured":"Draycott TJ, Crofts JF, Ash JP, Improving neonatal outcome through practical shoulder dystocia training. Obstet Gynecol. 2008;112(1):14\u201320."},{"issue":"4","key":"b21","series-title":"Am J Obstet Gynecol","first-page":"322.e1","article-title":"Effects of shoulder dystocia training on the incidence of brachial plexus injury","volume":"204","author":"Inglis SR","year":"2011","unstructured":"Inglis SR, Feier N, Chetiyaar JB, Effects of shoulder dystocia training on the incidence of brachial plexus injury. Am J Obstet Gynecol. 2011;204(4):322.e1\u2013322.e6."},{"issue":"12","key":"b22","series-title":"Eur J Clin Nutr","first-page":"1757","article-title":"Obesity in pregnant women: a 20-year analysis of the German experience","volume":"75","author":"Strauss A","year":"2021","unstructured":"Strauss A, Rochow N, Kunze M, Hesse V, Dudenhausen JW, Voigt M. Obesity in pregnant women: a 20-year analysis of the German experience. Eur J Clin Nutr. 2021;75(12):1757\u20131763."},{"issue":"10","key":"b23","series-title":"PLoS One","first-page":"e0276406","article-title":"Fetal malposition in labour and health outcomes for women and their newborn infants: a retrospective cohort study","volume":"17","author":"Barrowclough J","year":"2022","unstructured":"Barrowclough J, Kool B, Crowther C. Fetal malposition in labour and health outcomes for women and their newborn infants: a retrospective cohort study. 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Ultrasound Obstet Gynecol. 2004;24(4):425\u2013428."},{"issue":"3","key":"b26","series-title":"Br J Surg","first-page":"236","article-title":"Accuracy of surgical complication rate estimation using ICD-10 codes","volume":"106","author":"Storesund A","year":"2019","unstructured":"Storesund A, Haugen AS, Hjort\u00e5s M, Accuracy of surgical complication rate estimation using ICD-10 codes. 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