Moura Cristiano S, Morrison Laurie J, Hohl Corinne M, Grant Lars, Pilote Louise, Neville Autumn, Hau Jeffrey P, Bernatsky Sasha
McGill University, Montreal, QC, Canada.
Department of Emergency Services, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Sci Rep. 2024 Mar 12;14(1):6008. doi: 10.1038/s41598-023-49501-7.
We estimated the operating characteristics of ICD-10 code U07.1, introduced by the World Health Organization in 2020, to identify lab-confirmed SARS-CoV-2. CCEDRRN is a national research registry of adults (March 2020-August 2021) with suspected/confirmed SARS-CoV-2 identified in Canadian emergency departments (EDs) using chart review (symptoms, clinical information, and lab test results including SARS-CoV-2 polymerase chain reaction, PCR results). CCEDRRN data were linked to administrative hospitalization discharge and ED ICD-10 diagnostic codes (accessed centrally via the Canadian Institute for Health Information). We identified ICD-10 diagnostic codes in CCEDRRN participants. We defined lab-confirmed SARS-CoV-2 based on at least one positive PCR in the 0-14 days before the ED presentation and/or during hospitalization (in those admitted from ED). We performed separate analyses for CCEDRRN participants discharged from ED and those hospitalized from the ED. Additional analyses were stratified by province, sex, age, and (for hospitalized patients) timing of the first PCR test. The sensitivity of ICD-10 code U07.1 for a positive SARS-CoV-2 test was 93.6% (95% CI 93.0-94.1%) in those hospitalized from ED and 83.0% (95% CI 82.1-83.9%) in those discharged from the ED. Sensitivity was similar across provinces and demographics, but in each stratified analysis, values were higher in those hospitalized versus those discharged from ED. The ICD-10 diagnostic code for U07.1 within administrative data identified most lab-confirmed SARS-CoV-2 within persons hospitalized from ED, although a significant number of cases discharged from ED were missed. This should be considered when using administrative data for research and public health planning.
我们评估了世界卫生组织于2020年引入的用于识别实验室确诊的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的国际疾病分类第十版（ICD-10）编码U07.1的运行特征。加拿大急诊室确诊登记研究网络（CCEDRRN）是一项针对成年人（2020年3月至2021年8月）的全国性研究登记，这些成年人在加拿大急诊科因疑似/确诊SARS-CoV-2接受检查，通过病历审查（症状、临床信息以及包括SARS-CoV-2聚合酶链反应即PCR结果在内的实验室检测结果）进行识别。CCEDRRN数据与行政住院出院数据以及急诊科ICD-10诊断编码相关联（通过加拿大卫生信息研究所集中获取）。我们在CCEDRRN参与者中识别ICD-10诊断编码。我们根据急诊科就诊前0至14天内和/或住院期间（对于从急诊科收治的患者）至少一次PCR检测呈阳性来定义实验室确诊的SARS-CoV-2。我们对从急诊科出院的CCEDRRN参与者和从急诊科住院的参与者分别进行了分析。额外的分析按省份、性别、年龄以及（对于住院患者）首次PCR检测时间进行分层。对于从急诊科住院的患者，ICD-10编码U07.1对SARS-CoV-2检测呈阳性的敏感性为93.6%（95%置信区间93.0 - 94.1%），对于从急诊科出院的患者为83.0%（95%置信区间82.1 - 83.9%）。各省和不同人口统计学特征的敏感性相似，但在每项分层分析中，住院患者的值高于从急诊科出院的患者。行政数据中的ICD-10诊断编码U07.1识别出了大多数从急诊科住院的实验室确诊的SARS-CoV-2病例，尽管有相当数量从急诊科出院的病例被遗漏。在将行政数据用于研究和公共卫生规划时应考虑到这一点。
