Moura Cristiano S, Neville Autumn, Liao Fangming, Wen Bijun, Razak Fahad, Roberts Surain, Verma Amol A, Bernatsky Sasha
Faculty of Medicine (Moura, Bernatsky), McGill University; Research Institute of the McGill University Health Centre (Neville, Bernatsky), Montréal, Que.; Li Ka Shing Knowledge Institute, St. Michael's Hospital (Liao, Wen, Razak, Roberts, Verma), Unity Health Toronto; Department of Medicine (Razak, Verma) and Institute of Health Policy, Management and Evaluation (Razak, Roberts, Verma), University of Toronto, Toronto, Ont.
CMAJ Open. 2023 Oct 24;11(5):E982-E987. doi: 10.9778/cmajo.20230033. Print 2023 Sep-Oct.
In 2020, (ICD-10) codes were created for laboratory-confirmed SARS-CoV-2 infections. We assessed the operating characteristics of ICD-10 discharge diagnostic code U07.1 within the General Medicine Inpatient Initiative (GEMINI).
GEMINI assembles hospitalization data (including administrative ICD-10 discharge diagnostic codes, laboratory results and demographic data) from hospitals in Ontario, Canada. We studied adults (age ≥ 18 yr) admitted during 2020 and tested at least once for SARS-CoV-2 via polymerase chain reaction (PCR) during (or within 48 h before) hospitalization. With PCR results as the reference standard, we calculated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for ICD-10 code U07.1 hospital discharge diagnostic codes. Analyses were stratified by demographic data, calendar period and timing of the first test (within or after 48 h of hospital admission).
In 11 852 hospitalizations with at least 1 SARS-CoV-2 PCR test, 444 (3.7%) were positive. The sensitivity of code U07.1 to identify SARS-CoV-2 infection was 97.8%, specificity was 99.5%, PPV was 88.2% and NPV was 99.9%. Operating characteristics were similar in most stratified analyses, but the specificity and PPV were lower if the first SARS-CoV-2 test was done more than 48 hours after admission.
The sensitivity, specificity, PPV and NPV of code U07.1 were high. This supports using code U07.1 to identify SARS-CoV-2 infection in hospitalization data.
2020年，为实验室确诊的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染制定了国际疾病分类第十版（ICD-10）编码。我们在综合内科住院患者计划（GEMINI）中评估了ICD-10出院诊断编码U07.1的运行特征。
GEMINI收集了加拿大安大略省各医院的住院数据（包括行政ICD-10出院诊断编码、实验室检查结果和人口统计学数据）。我们研究了2020年期间入院的成年人（年龄≥18岁），并在住院期间（或住院前48小时内）至少进行了一次SARS-CoV-2聚合酶链反应（PCR）检测。以PCR结果作为参考标准，我们计算了ICD-10编码U07.1出院诊断编码的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。分析按人口统计学数据、日历时间段和首次检测时间（入院后48小时内或之后）进行分层。
在11852例至少进行过1次SARS-CoV-2 PCR检测的住院病例中，444例（3.7%）呈阳性。编码U07.1识别SARS-CoV-2感染的敏感性为97.8%，特异性为99.5%，PPV为88.2%，NPV为99.9%。在大多数分层分析中，运行特征相似，但如果首次SARS-CoV-2检测在入院后48小时以上进行，特异性和PPV较低。
编码U07.1的敏感性、特异性、PPV和NPV都很高。这支持在住院数据中使用编码U07.1来识别SARS-CoV-2感染。
