国际疾病分类第 10 版编码对肝硬化及门静脉高压并发症的准确性。
Accuracy of International Classification of Diseases-10 Codes for Cirrhosis and Portal Hypertensive Complications.
机构信息
Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA.
出版信息
Dig Dis Sci. 2022 Aug;67(8):3623-3631. doi: 10.1007/s10620-021-07282-x. Epub 2021 Oct 21.
BACKGROUND AND AIMS
International Classification of Diseases (ICD)-10 codes may correspond to cirrhosis diagnosis. However, these codes have not been as well studied as ICD-9 codes. We aimed to evaluate the positive predictive value (PPV) and specificity of ICD-10 codes for cirrhosis.
METHODS
We conducted a single-center retrospective study of patients in Michigan Medicine (Ann Arbor, MI, USA). We evaluated patients with at least one of 28 ICD-10 codes for cirrhosis and randomly selected controls for the presence of cirrhosis and/or portal hypertensive complications.
RESULTS
Among 1317 patients with at least one ICD-10 code consistent with cirrhosis and/or portal hypertension, 796 had confirmed cirrhosis. After excluding ICD-10 codes found in < 10 patients, we evaluated the PPV of the 19 remaining codes. Of these, 15 had a high PPV for cirrhosis (> 80%), including codes for cirrhosis itself, gastroesophageal varices, hepatic encephalopathy, and other portal hypertensive complications. Specificity of ICD codes for cirrhosis for these 15 codes was high (> 94% for all). PPV and specificity were high across liver disease etiologies. Among patients without portal hypertension, PPVs of ICD-10 codes for cirrhosis were lower but still > 80% for the most common codes. PPVs of most codes for portal hypertensive complications were > 70%. Defining cirrhosis based on the presence of any of the 15 codes resulted in a PPV of 86% and by two different codes, a PPV 94%.
CONCLUSIONS
ICD-10 codes for cirrhosis can accurately identify patients with cirrhosis with or without portal hypertensive complications.
背景与目的
国际疾病分类（ICD）-10 代码可能与肝硬化诊断相对应。然而，这些代码的研究还不如 ICD-9 代码充分。我们旨在评估 ICD-10 代码诊断肝硬化的阳性预测值（PPV）和特异性。
方法
我们进行了一项密歇根医学中心（美国密歇根州安娜堡）的单中心回顾性研究。我们评估了至少有 28 个 ICD-10 肝硬化代码之一的患者，并随机选择对照组以确定是否存在肝硬化和/或门静脉高压并发症。
结果
在 1317 例至少有一个与肝硬化和/或门静脉高压一致的 ICD-10 代码的患者中，796 例患者经证实患有肝硬化。在排除了 10 例以下患者的 ICD-10 代码后，我们评估了其余 19 个代码的 PPV。其中，15 个代码具有高肝硬化 PPV（>80%），包括肝硬化本身、胃食管静脉曲张、肝性脑病和其他门静脉高压并发症的代码。对于这 15 个代码，ICD 代码诊断肝硬化的特异性很高（所有代码均>94%）。肝硬化的病因对 PPV 和特异性均无显著影响。在没有门静脉高压的患者中，肝硬化的 ICD-10 代码的 PPV 较低，但对于最常见的代码，其仍>80%。大多数门静脉高压并发症代码的 PPV>70%。根据任何 15 个代码的存在定义肝硬化可导致 86%的 PPV，而根据两个不同的代码，PPV 为 94%。
结论
ICD-10 代码可准确识别有或无门静脉高压并发症的肝硬化患者。
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