Kentucky Injury Prevention and Research Center, University of Kentucky, Lexington, Kentucky, USA.
Sociology, University of Kentucky, Lexington, Kentucky, USA.
Inj Prev. 2021 Mar;27(S1):i9-i12. doi: 10.1136/injuryprev-2019-043512.
The purpose of this study was to estimate the positive predictive value (PPV) of International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes for injury, poisoning, physical or sexual assault complicating pregnancy, childbirth and the puerperium (PCP) to capture injury encounters within both hospital and emergency department claims data.
A medical record review was conducted on a sample (n=157) of inpatient and emergency department claims from one Kentucky healthcare system from 2015 to 2017, with any diagnosis in the ICD-10-CM range O9A.2-O9A.4. Study clinicians reviewed medical records for the sampled cases and used an abstraction form to collect information on documented presence of injury and PCP complications. The study estimated the PPVs and the 95% CIs of O9A.2-O9A.4 codes for (1) capturing injuries and (2) capturing injuries complicating PCP.
The estimated PPV for the codes O9A.2-O9A.4 to identify injury in the full sample was 79.6% (95% CI 73.3% to 85.9%) and the PPV for capturing injuries complicating PCP was 72.0% (95% CI 65.0% to 79.0%). The estimated PPV for an inpatient principal diagnosis O9A.2-O9A.4 to capture injuries was 90.7% (95% CI 82.0% to 99.4%) and the PPV for capturing injuries complicating PCP was 88.4% (95% CI 78.4% to 98.4%). The estimated PPV for any mention of O9A.2-O9A.4 in emergency department data to capture injuries was 95.2% (95% CI 90.6% to 99.9%) and the PPV for capturing injuries complicating PCP was 81.0% (95% CI 72.4% to 89.5%).
The O9A.2-O9A.4 codes captured high percentage true injury cases among pregnant and puerperal women.
本研究旨在评估国际疾病分类，第 10 修订版，临床修正版（ICD-10-CM）编码对伤害、中毒、身体或性侵犯合并妊娠、分娩和产褥期（PCP）的阳性预测值（PPV），以捕捉医院和急诊部门索赔数据中的伤害事件。
对肯塔基州一个医疗系统 2015 年至 2017 年的住院和急诊部门索赔中的样本（n=157）进行了病历审查，ICD-10-CM 范围内的任何诊断 O9A.2-O9A.4。研究临床医生审查了抽样病例的病历，并使用摘要表格收集有关记录的伤害和 PCP 并发症存在的信息。该研究估计了 O9A.2-O9A.4 编码对（1）捕捉伤害和（2）捕捉 PCP 合并伤害的 PPV 及其 95%置信区间。
在全样本中，O9A.2-O9A.4 编码识别伤害的估计 PPV 为 79.6%（95%CI 73.3%至 85.9%），捕捉 PCP 合并伤害的 PPV 为 72.0%（95%CI 65.0%至 79.0%）。住院患者主要诊断 O9A.2-O9A.4 捕捉伤害的估计 PPV 为 90.7%（95%CI 82.0%至 99.4%），捕捉 PCP 合并伤害的 PPV 为 88.4%（95%CI 78.4%至 98.4%）。急诊数据中任何 O9A.2-O9A.4 提及的估计 PPV 为 95.2%（95%CI 90.6%至 99.9%），捕捉 PCP 合并伤害的 PPV 为 81.0%（95%CI 72.4%至 89.5%）。
O9A.2-O9A.4 编码在妊娠和产褥期妇女中捕捉到了高比例的真实伤害病例。
