Hønge Bo Langhoff, Hansen Kristoffer Skaalum, Thomsen Marianne Kragh, Østergaard Lars, Mogensen Trine Hyrup, Storgaard Merete, Erikstrup Christian, Sørup Signe
. Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark; . Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.
. Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.
Ann Epidemiol. 2025 Feb;102:62-67. doi: 10.1016/j.annepidem.2024.12.017. Epub 2025 Jan 8.
The accuracy of recorded diagnosis codes for hospital admissions due to influenza in the Danish national registries is uncertain. We evaluated positive predictive value (PPV) and sensitivity of ICD-10 codes for influenza by comparing to the reference standard of influenza test results.
Hospital admissions were assessed in the Danish National Patient Registry (DNPR), and influenza test results in the Danish Microbiology Database (MiBa). First, we report the proportion of positive influenza virus tests within seven days of admission among hospital admissions with a discharge influenza ICD-10 code (PPV). Second, we report the proportion with ICD-10 codes for influenza among patients with an admission registered with seven days of a positive influenza virus test (sensitivity).
From January 2012 - November 2022 a total of 18,761 admissions were registered with one of the 22 influenza ICD-10 codes in DNPR. Overall, there was a positive influenza test in 16,754 of the admissions (87.9 % = overall PPV, 95 % CI: 87.4-88.3). The PPV was highest for older patient groups (93.7 % in patients >80 years vs. 78.0 % in patients < 11 years), and for admissions that occurred in recent years (95.8 % in 2022 vs. 52.4 % in 2012). Among 33,834 hospitals admissions with a positive influenza test, less than half (n = 16,421, 48.5 % = sensitivity (95 % CI: 48.0 - 49.1 %)) were registered with an influenza ICD-10 code.
ICD-10 diagnoses codes have relatively high positive predictive value, but the sensitivity is low. Furthermore, the PPV depend on age and calendar year.
丹麦国家登记处中因流感住院的记录诊断代码的准确性尚不确定。我们通过与流感检测结果的参考标准进行比较，评估了国际疾病分类第十版（ICD - 10）流感代码的阳性预测值（PPV）和敏感性。
在丹麦国家患者登记处（DNPR）评估住院情况，并在丹麦微生物数据库（MiBa）中获取流感检测结果。首先，我们报告在出院时带有流感ICD - 10代码的住院患者中，入院后七天内流感病毒检测呈阳性的比例（PPV）。其次，我们报告在流感病毒检测呈阳性登记入院的患者中，带有ICD - 10流感代码的患者比例（敏感性）。
2012年1月至2022年11月期间，DNPR中共有18,761例住院患者登记了22种ICD - 10流感代码中的一种。总体而言，16,754例住院患者的流感检测呈阳性（总体PPV为87.9%，95%置信区间：87.4 - 88.3）。老年患者组的PPV最高（80岁以上患者为93.7%，11岁以下患者为78.0%），近年来入院的患者PPV也较高（2022年为95.8%，2012年为52.4%）。在33,834例流感检测呈阳性的住院患者中，不到一半（n = 16,421，敏感性为48.5%（95%置信区间：48.0 - 49.1%））登记了ICD - 10流感代码。
ICD - 10诊断代码具有相对较高的阳性预测值，但敏感性较低。此外，PPV取决于年龄和日历年份。
