Diagnosis of Influenza: Only a Problem of Coding?
Diagnosis of Influenza: Only a Problem of Coding?
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DOI：
10.1159/000364780
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发表时间：
2014-01-01
影响因子：
3.2
通讯作者：
Vitale, Francesco
中科院分区：
文献类型：
--
作者：
Amodio, Emanuele;Tramuto, Fabio;Vitale, Francesco
目的：评估使用特定国际疾病分类第9版临床修改（ICD-9 CM）代码测量的流感出院诊断特征。受试者和方法：本研究于2007年、2008年和2011年进行。该数据库包括（1）入住急诊医院的西西里患者的管理和临床数据和（2）来自10个欧洲国家的流感病毒学监测数据（FluNet数据库）。所有诊断为至少1个ICD-9 CM流感代码（487.0、487.1和487.9）的西西里患者均被视为流感病例。结果如下：总体而言，西西里有2，880例ICD-9 CM编码的流感患者住院：2，119例（73.6%）在11月至4月期间住院，而761例（26.4%）在5月至10月期间住院。在研究的3年中，分析的欧洲流感监测系统记录了11月至4月实验室确认的流感活动高峰，有36，753例（99.7%）流感病例，而5月至10月仅观察到124例（0.3%）。结论：在西西里，在流感病毒传播可忽略不计的月份中，观察到超过四分之一的ICD-9 CM流感代码住院患者。我们的研究结果表明，一些医院出院记录包括ICD-9 CM编码的流感与低水平的敏感性，特异性和/或适当的临床信息，并支持需要改善医学教育的流行病学和医院管理的流感病例。(C)2014 S. Karger AG，巴塞尔
Objective: To evaluate the characteristics of hospital discharge diagnoses of influenza measured by using specific International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9 CM) codes. Subjects and Methods: The study was conducted for the 3 years 2007, 2008 and 2011. The database included (1) administrative and clinical data on Sicilian patients admitted to acute care hospitals and (2) data from the influenza virological surveillance of 10 European countries (FluNet database). All Sicilian patients diagnosed with at least 1 ICD-9 CM code for influenza (487.0, 487.1 and 487.9) were considered influenza cases. Results: Overall, 2,880 patients with an ICD-9 CM code attributable to influenza were hospitalized in Sicily: 2,119 (73.6%) were admitted from November to April, whereas 761 (26.4%) were admitted from May to October. In the 3 years studied, the analyzed European influenza surveillance systems recorded a peak of laboratory-confirmed influenza activity from November to April with 36,753 (99.7%) influenza cases, whereas only 124 cases (0.3%) were observed from May to October. Conclusions: In Sicily, more than one quarter of all hospital admissions with an ICD-9 CM code for influenza were observed in the months with a negligible circulation of influenza viruses. Our findings show that several hospital discharge records included ICD-9 CM codes for influenza with low levels of sensitivity, specificity and/or appropriateness for clinical information and support the need for improving medical education on the epidemiology and hospital management of influenza cases. (C) 2014 S. Karger AG, Basel