| Evaluation of the predictive value of ICD-9-CM coded administrative data for venous thromboembolism in the United States. | |
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MedLine Citation:
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PMID: 20430419 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine the positive predictive value of International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM) discharge codes for acute deep vein thrombosis or pulmonary embolism. MATERIALS AND METHODS: Retrospective review of 3456 cases hospitalized between 2005 and 2007 that had a discharge code for venous thromboembolism, using 3 sample populations: a single academic hospital, 33 University HealthSystem Consortium hospitals, and 35 community hospitals in a national Joint Commission study. Analysis was stratified by position of the code in the principal versus a secondary position. RESULTS: Among 1096 cases that had a thromboembolism code in the principal position the positive predictive value for any acute venous thrombosis was 95% (95%CI:93-97), whereas among 2360 cases that had a thromboembolism code in a secondary position the predictive value was lower, 75% (95%CI:71-80). The corresponding positive predictive values for lower extremity deep-vein thrombosis or pulmonary embolism were 91% (95%CI:86-95) and 50% (95%CI:41-58), respectively. More highly defined codes had higher predictive value. Among codes in a secondary position that were false positive, 22% (95%CI:16-27) had chronic/prior venous thrombosis, 15% (95%CI:10-19) had an upper extremity thrombosis, 6% (95%CI:4-8) had a superficial vein thrombosis, and 7% (95%CI:4-13) had no mention of any thrombosis. CONCLUSIONS: ICD-9-CM codes for venous thromboembolism had high predictive value when present in the principal position, and lower predictive value when in a secondary position. New thromboembolism codes that were added in 2009 that specify chronic thrombosis, upper extremity thrombosis and superficial venous thrombosis should reduce the frequency of false-positive thromboembolism codes. |
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Authors:
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Richard H White; Martina Garcia; Banafsheh Sadeghi; Daniel J Tancredi; Patricia Zrelak; Joanne Cuny; Pradeep Sama; Harriet Gammon; Stephen Schmaltz; Patrick S Romano |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. Date: 2010-04-28 |
Journal Detail:
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Title: Thrombosis research Volume: 126 ISSN: 1879-2472 ISO Abbreviation: Thromb. Res. Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-06-14 Completed Date: 2010-09-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0326377 Medline TA: Thromb Res Country: United States |
Other Details:
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Languages: eng Pagination: 61-7 Citation Subset: IM |
Copyright Information:
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Copyright (c) 2010 Elsevier Ltd. All rights reserved. |
Affiliation:
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Division of General Medicine, University of California, Davis, CA, USA. rhwhite@ucdavis.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Female Hospitals, University Humans International Classification of Diseases Male Middle Aged Pulmonary Embolism Retrospective Studies Thromboembolism United States / epidemiology Venous Thromboembolism / epidemiology* Venous Thrombosis |
| Grant Support | |
ID/Acronym/Agency:
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290-04-0020//PHS HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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