恶性高热在出院记录中的诊断准确性。

Accuracy of malignant hyperthermia diagnoses in hospital discharge records.

机构信息

From the Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, New York (T.P., B.H.L.); Department of Medical Education and Clinical Research, Saint Barnabas Medical Center, Livingston, New Jersey (H.R.); Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (C.A.W.); Department of Anesthesiology, Toronto General Hospital, Toronto, Ontario, Canada (S.R.); Departments of Anesthesiology and Epidemiology, Columbia University College of Physicians and Surgeons and Mailman School of Public Health, New York, New York (J.E.B., G.L.); and Departments of Anesthesiology and Pediatrics, Columbia University College of Physicians and Surgeons, New York, New York (L.S.S.).

出版信息

Anesthesiology. 2015 Jan;122(1):55-63. doi: 10.1097/ALN.0000000000000467.

DOI:10.1097/ALN.0000000000000467

PMID:25272246

Abstract

BACKGROUND

In 1997, the International Classification of Diseases (ICD), 9th Revision Clinical Modification (ICD-9) coding system introduced the code for malignant hyperthermia (MH) (995.86). The aim of this study was to estimate the accuracy of coding for MH in hospital discharge records.

METHODS

An expert panel of anesthesiologists reviewed medical records for patients with a discharge diagnosis of MH based on ICD-9 or ICD-10 codes from January 1, 2006 to December 31, 2008 at six tertiary care medical centers in North America. All cases were categorized as possible, probable, or fulminant MH, history of MH (family or personal) or other.

RESULTS

A total of 47 medical records with MH diagnoses were reviewed; 68.1% had a documented surgical procedure and general anesthesia, and 23.4% (95% CI, 12.3-38.0%) had a possible, probable, or fulminant MH event. Dantrolene was given in 81% of the MH events. All patients judged to have an incident MH event survived to discharge. Family and personal history of MH accounted for 46.8% of cases. High fever without evidence of MH during admission accounted for 23.4%, and the reason for MH coding was unclear in 6.4% of cases.

CONCLUSIONS

Approximately one quarter of ICD-9 or ICD-10 coded MH diagnoses in hospital discharge records refer to incident MH episodes and an additional 47% to MH susceptibility (including personal history or family history). Information such as surgical procedure, anesthesia billing data, and dantrolene administration may aid in identifying incident MH cases among those with an ICD-9 or ICD-10 coded MH diagnosis in their hospital discharge records.

摘要

背景

1997 年，国际疾病分类（ICD）第 9 修订版临床修正（ICD-9）编码系统引入了恶性高热（MH）的编码（995.86）。本研究的目的是评估医院出院记录中 MH 编码的准确性。

方法

一个麻醉专家的专家小组根据 ICD-9 或 ICD-10 代码，审查了 2006 年 1 月 1 日至 2008 年 12 月 31 日在北美六个三级医疗中心有 MH 出院诊断的患者的病历。所有病例均归类为可能、可能或暴发性 MH、MH 病史（家族或个人）或其他。

结果

共审查了 47 份有 MH 诊断的病历；68.1%有记录的手术和全身麻醉，23.4%（95%可信区间，12.3-38.0%）有可能、可能或暴发性 MH 事件。81%的 MH 事件中使用了丹曲林。所有被判断为有 MH 事件的患者都存活至出院。MH 家族和个人史占病例的 46.8%。住院期间高热无 MH 证据占 23.4%，6.4%的病例 MH 编码原因不明。