International Classification of Diseases, 9th Revision, Clinical Modification Codes in Discharge Abstracts Are Poor Measures of Complication Occurrence in Medical Inpatients

Jane M. Geraci, Carol M. Ashton, David H. Kuykendall, Michael L. Johnson, Louise Wu

Research output: Contribution to journalArticle

59 Scopus citations

Abstract

OBJECTIVES. The authors tested the ability of International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes in discharge abstracts to identify medical inpatients who experienced an in-hospital complication, using complications identified through chart review as the gold standard. METHODS. Two sets of ICD-9-CM codes were used: an inclusive set including many medical diagnoses that may also be coexistent complicating conditions on admission rather than complications and an exclusive set consisting primarily of ICD-9-CM-specified complication and adverse drug event codes. RESULTS. Neither set performed well as a diagnostic test for complication occurrence according to receiver operating characteristic analysis (ROC areas were 0.61 for the inclusive set and 0.55 for the exclusive set). Sensitivities of the ICD-9-CM codes for complications were 0.34 for the inclusive set and 0.14 for the exclusive set. Corresponding positive predictive values were 0.32 and 0.37, respectively. Sensitivities of code definitions for individual complications were generally poor, less than 0.5 in most cases. CONCLUSIONS. The authors conclude that ICD-9-CM codes in discharge abstracts are poor measures of complication occurrence.

Original languageEnglish (US)
Pages (from-to)589-602
Number of pages14
JournalMedical Care
Volume35
Issue number6
DOIs
StatePublished - Jun 1997

Keywords

  • Administrative data bases
  • Adverse events
  • Complications
  • ICD-9-CM

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Nursing(all)
  • Health(social science)
  • Health Professions(all)

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