Identification of Inpatient Allergic Drug Reactions Using ICD-9-CM Codes
Identification of Inpatient Allergic Drug Reactions Using ICD-9-CM Codes
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DOI：
10.1016/j.jaip.2018.07.022
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发表时间：
2019-01-01
影响因子：
9.4
通讯作者：
Banerji, Aleena
中科院分区：
文献类型：
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作者：
Saff, Rebecca R.;Li, Yu;Banerji, Aleena
背景技术背景：药物过敏反应的研究一直受到限制，因为在识别和确认病例的挑战。目的：确定国际疾病分类，第九次修订，临床修改的效用（ICD-9-CM）代码识别住院患者过敏药物反应，并将结果与急诊科以前的数据进行比较。通过回顾一家大型城市学术医疗中心的ICD-9-CM编码和E编码提示药物过敏反应的住院患者的病历，我们确定了产生最多药物过敏病例的编码，并确定了罪魁祸首药物。在2005年和2010年，确定了3337例和5282例住院期间可能的药物过敏反应，并对1367例进行了审查。在409例（30.1%）审查的图表中发现了过敏药物反应，2005年为172例（29.7%），2010年为237例（30.5%）。确定最高百分比的真实药物过敏反应的代码为药物性皮炎（693.0）、过敏性荨麻疹（708）、血管神经性水肿（995.1）和速发过敏反应（995.0）。抗生素是最常见的原因（44.4%），然而，多个药物类别往往被确定为可能的罪魁祸首drugs.CONCLUSION：特定的ICD-9-CM代码可以识别患者的药物过敏反应，抗生素占近一半的真实反应。代码为693.0、995.1、708和995.0的大多数患者发生药物过敏反应，其中693.0为最高发生率代码。多个特定代码的汇总一致地识别了确认发生药物过敏反应的患者队列。(C)2019年美国过敏、哮喘和免疫学会
BACKGROUND: The study of allergic drug reactions has been limited because of challenges in identifying and confirming cases.OBJECTIVE: To determine the utility of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for identifying inpatient allergic drug reactions and to compare findings with previous data in the emergency department.METHODS: By reviewing medical records of inpatients with ICD-9-CM codes and E codes suggestive of allergic drug reactions at a large urban academic medical center, we determined codes that yielded the most drug allergy cases and identified culprit drugs.RESULTS: In 2005 and 2010, 3337 and 5282 possible allergic drug reactions during hospitalization were identified and 1367 were reviewed. Allergic drug reactions were found in 409 (30.1%) of the reviewed charts, with 172 (29.7%) in 2005 and 237 (30.5%) in 2010. The codes that identified the highest percentage of true allergic drug reactions were dermatitis due to drug (693.0), allergic urticaria (708), angioneurotic edema (995.1), and anaphylaxis (995.0). Antibiotics were the most common cause (44.4%); however, multiple drug classes were often identified as likely culprit drugs.CONCLUSION: Specific ICD-9-CM codes can identify patients with allergic drug reactions, with antibiotics accounting for almost half of true reactions. Most patients with codes 693.0, 995.1, 708, and 995.0 had allergic drug reactions, with 693.0 as the highest yield code. An aggregate of multiple specific codes consistently identifies a cohort of patients with confirmed allergic drug reactions. (C) 2019 American Academy of Allergy, Asthma & Immunology