Warwick James, Slavova Svetla, Bush Joshua, Costich Julia
College of Medicine, University of Kentucky , Lexington, KY, USA.
Kentucky Injury Prevention and Research Center, University of Kentucky , Lexington, USA.
Brain Inj. 2020 Dec 5;34(13-14):1763-1770. doi: 10.1080/02699052.2020.1849801. Epub 2020 Dec 6.
: Using inpatient data from a 1,160-bed health system, we assessed the positive predictive value (PPV) of ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification) codes included in a traumatic brain injury (TBI) surveillance definition proposed by the Centers for Disease Control and Prevention (CDC) in 2016. : A random sample of 196 records with ICD-10-CM TBI codes was reviewed. The PPVs for the ICD-10-CM codes' ability to capture true TBI cases were calculated as the percentage of records with confirmed clinical provider-documented TBI and reported with 95% confidence intervals [95%CIs]. : The estimated overall PPV was 74% [67.9%, 80.1%] when the codes were listed in any diagnostic field, but 91.5% [86.2%, 96.8%] when listed as the principal diagnosis. S06 codes (intracranial injury) had an overall PPV of 80.2% [74.3%, 86.1%] and 96.9% [93.3%, 100%] when listed as the principal diagnosis. S02.0-.1 codes (vault/base skull fractures) in any position without co-existing S06 codes had a PPV of 15.8% [0%, 33.2%]. : Intracranial injury codes (S06) in any diagnostic position had a very high estimated PPV. Further research is needed to determine the utility of other codes included in the CDC proposed definition for TBI surveillance.
利用一家拥有1160张床位的医疗系统的住院患者数据,我们评估了疾病控制与预防中心(CDC)2016年提出的创伤性脑损伤(TBI)监测定义中所包含的国际疾病分类第十版临床修订本(ICD - 10 - CM)编码的阳性预测值(PPV)。
回顾了196条带有ICD - 10 - CM TBI编码的记录的随机样本。ICD - 10 - CM编码捕捉真正TBI病例能力的PPV计算为临床医生记录确认的TBI记录的百分比,并报告其95%置信区间[95%CI]。
当编码列在任何诊断字段中时,估计的总体PPV为74%[67.9%,80.1%],但列为主要诊断时为91.5%[86.2%,96.8%]。S06编码(颅内损伤)列为主要诊断时,总体PPV为80.2%[74.3%,86.1%],列为主要诊断时为96.9%[93.3%,100%]。任何位置且无并存S06编码的S02.0-.1编码(颅盖/颅底骨折)的PPV为15.8%[0%,33.2%]。
任何诊断位置的颅内损伤编码(S06)估计PPV非常高。需要进一步研究以确定CDC提出的TBI监测定义中包含的其他编码的效用。