Validity of ICD-10 codes for COVID-19 patients with hospital admissions or ED visits in Canada: a retrospective cohort study.
Validity of ICD-10 codes for COVID-19 patients with hospital admissions or ED visits in Canada: a retrospective cohort study.
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DOI：
10.1136/bmjopen-2021-057838
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发表时间：
2022-01-21
期刊：
影响因子：
2.9
通讯作者：
Xu Y
中科院分区：
文献类型：
--
作者：
Wu G;D'Souza AG;Quan H;Southern DA;Youngson E;Williamson T;Eastwood C;Xu Y
评价《新冠肺炎国际疾病分类第十版》（ICD-10）编码及其组合的有效性。回顾性队列研究。加拿大阿尔伯塔省的急症护理医院和急诊科。当地行政数据库在2020年3月1日至2021年2月28日期间捕获的在阿尔伯塔省住院或到急诊室就诊的患者，他们的COVID-19检测呈阳性和/或与COVID-19相关的ICD-10代码。计算ICD-10编码的敏感性、阳性预测值（PPV）和95% ci。分层分析患者的年龄、性别、症状、机械通气情况、医院类型、重症监护病房（ICU）入院、出院情况及流行季节。研究人群中考虑了两个重叠的子集：COVID-19检测阳性的患者（用于估计敏感性的队列a）和具有COVID-19相关ICD-10代码的患者（用于估计PPV的队列B）。A组包括17 979例ED患者和6477例住院患者，B组包括33 675例ED患者和18 746例住院患者。在住院患者中，队列A的9.5%和队列B的8.1%接受了机械通气。超过13%的住院患者入住ICU。队列A的住院时间为6天（IQR: 3-14），队列B的住院时间为8天（IQR: 3-19），队列A和队列B的住院死亡率分别为15.9%和38.8%。ICD-10代码U07.1 （COVID-19，病毒鉴定）的敏感性为82.5% (81.8% ~ 83.2%)，PPV为93.1%（92.6% ~ 93.6%）。合并U07.1和U07.3（与COVID-19相关的多系统炎症综合征）的敏感性为82.5% (81.9% ~ 83.2%)，PPV为92.9%（92.4% ~ 93.4%）。在艾伯塔省，ICD-10 COVID-19代码（U07.1和U07.3）编码良好，效度高。这表明行政数据可用于COVID-19研究和大流行管理目的。
To evaluate the validity of COVID-19 International Classification of Diseases, 10th Revision (ICD-10) codes and their combinations. Retrospective cohort study. Acute care hospitals and emergency departments (EDs) in Alberta, Canada. Patients who were admitted to hospital or presented to an ED in Alberta, as captured by local administrative databases between 1 March 2020 and 28 February 2021, who had a positive COVID-19 test and/or a COVID-19-related ICD-10 code. The sensitivity, positive predictive value (PPV) and 95% CIs for ICD-10 codes were computed. Stratified analysis on age group, sex, symptomatic status, mechanical ventilation, hospital type, patient intensive care unit (ICU) admission, discharge status and season of pandemic were conducted. Two overlapping subsets of the study population were considered: those who had a positive COVID-19 test (cohort A, for estimating sensitivity) and those who had a COVID-19-related ICD-10 code (cohort B, for estimating PPV). Cohort A included 17 979 ED patients and 6477 inpatients while cohort B included 33 675 ED patients and 18 746 inpatients. Of inpatients, 9.5% in cohort A and 8.1% in cohort B received mechanical ventilation. Over 13% of inpatients were admitted to ICU. The length of hospital stay was 6 days (IQR: 3–14) for cohort A and 8 days (IQR: 3–19) for cohort B. In-hospital mortality was 15.9% and 38.8% for cohort A and B, respectively. The sensitivity for ICD-10 code U07.1 (COVID-19, virus identified) was 82.5% (81.8%–83.2%) with a PPV of 93.1% (92.6%–93.6%). The combination of U07.1 and U07.3 (multisystem inflammatory syndrome associated with COVID-19) had a sensitivity of 82.5% (81.9%–83.2%) and PPV of 92.9% (92.4%–93.4%). In Alberta, ICD-10 COVID-19 codes (U07.1 and U07.3) were coded well with high validity. This indicates administrative data can be used for COVID-19 research and pandemic management purposes.
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