ICD-10 coding algorithms for defining comorbidities of acute myocardial infarction
ICD-10 coding algorithms for defining comorbidities of acute myocardial infarction
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DOI：
10.1186/1472-6963-6-161
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发表时间：
2006-12-15
影响因子：
2.8
通讯作者：
Quan, Hude
中科院分区：
文献类型：
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作者：
So, Lawrence;Evans, Dewey;Quan, Hude
背景：随着ICD-10在整个加拿大的引入，确保风险调整方法中使用的急性心肌梗死(AMI)共病保持有效和稳健是很重要的。因此，我们开发了9种急性心肌梗死并发症的ICD-10编码算法，检验了ICD-10和ICD-9编码算法在检测这些并存疾病方面的有效性，并评估了它们在预测死亡率方面的表现。我们检查的9种并发症分别是休克、糖尿病合并并发症、充血性心力衰竭、癌症、脑血管疾病、肺水肿、急性肾功能衰竭、慢性肾功能衰竭和心律失常。医生独立审查并确定清单上每一项的临床相关性。为了确保新开发的ICD-10编码算法在记录合并症方面是有效的，我们回顾了病历。在评估了ICD-10算法的有效性后，ICD-10和ICD-9算法被应用于加拿大省级医院出院数据库，以预测住院、30天和1年的死亡率。结果：与以图表回顾数据为标准相比，ICD-9和ICD-10数据对所研究的9种急性心肌梗死的敏感性(7.1-100%)和特异度(93.6%以上)相似。1994年至2004年间，加拿大某省49,861名急性心肌梗死患者的ICD-9和ICD-10编码算法的合并症频率相似。ICD-9(0.82)和ICD-10(0.81)用于预测30天和1年死亡率的C统计量相同。结论：本研究开发的用于确定急性心肌梗死合并症的ICD-10编码算法在检测病情和风险调整方面的表现与过去的ICD-9编码算法相似。然而，ICD-10编码算法还需要在外部数据库中进一步验证。
Background: With the introduction of ICD-10 throughout Canada, it is important to ensure that Acute Myocardial Infarction ( AMI) comorbidities employed in risk adjustment methods remain valid and robust. Therefore, we developed ICD-10 coding algorithms for nine AMI comorbidities, examined the validity of the ICD-10 and ICD-9 coding algorithms in detection of these comorbidities, and assessed their performance in predicting mortality. The nine comorbidities that we examined were shock, diabetes with complications, congestive heart failure, cancer, cerebrovascular disease, pulmonary edema, acute renal failure, chronic renal failure, and cardiac dysrhythmias.Methods: Coders generated a comprehensive list of ICD-10 codes corresponding to each AMI comorbidity. Physicians independently reviewed and determined the clinical relevance of each item on the list. To ensure that the newly developed ICD-10 coding algorithms were valid in recording comorbidities, medical charts were reviewed. After assessing ICD-10 algorithms' validity, both ICD-10 and ICD-9 algorithms were applied to a Canadian provincial hospital discharge database to predict in-hospital, 30-day, and 1-year mortality.Results: Compared to chart review data as a 'criterion standard', ICD-9 and ICD-10 data had similar sensitivities ( ranging from 7.1 - 100%), and specificities ( above 93.6%) for each of the nine AMI comorbidities studied. The frequencies for the comorbidities were similar between ICD-9 and ICD-10 coding algorithms for 49,861 AMI patients in a Canadian province during 1994 - 2004. The C-statistics for predicting 30-day and 1 year mortality were the same for ICD-9 (0.82) and for ICD-10 data (0.81).Conclusion: The ICD-10 coding algorithms developed in this study to define AMI comorbidities performed similarly as past ICD-9 coding algorithms in detecting conditions and risk-adjustment in our sample. However, the ICD-10 coding algorithms should be further validated in external databases.