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Accuracy of coding for possible warfarin complications in hospital discharge abstracts

, : Accuracy of coding for possible warfarin complications in hospital discharge abstracts. Thrombosis Research 118(2): 253-262

Hospital discharge abstracts could be used to identify complications of warfarin if coding for bleeding and thromboembolic events are accurate. To measure the accuracy of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9CM) codes for bleeding and thromboembolic diagnoses. University affiliated, tertiary care hospital in Ottawa, Canada. A random sample of patients discharged between September 1999 and September 2000 with an ICD-9-CM code indicating a bleeding or thromboembolic diagnosis. Gold-standard coding was determined by a trained chart abstractor using explicit standard diagnostic criteria for bleeding, major bleeding, and acute thromboembolism. The abstractor was blinded to the original coding. We calculated the sensitivity, specificity, positive, and negative predictive values of the original ICD-9CM codes for bleeding or thromboembolism diagnoses. We reviewed 616 medical records. 361 patients (59%) had a code indicating a bleeding diagnosis, 291 patients (47%) had a code indicating a thromboembolic diagnosis and 36 patients (6%) had a code indicating both. According to the gold standard criteria, 352 patients experienced bleeding, 333 experienced major bleeding, and 188 experienced an acute thromboembolism. For bleeding, the ICD-9CM codes had the following sensitivity, specificity, positive and negative predictive values [95% CI]: 93% [90-96], 88% [83-91], 91% [88-94], and 91% [87-94], respectively. For major bleeding, the ICD-9CM codes had the following sensitivity, specificity, positive and negative predictive values: 94% [91-96], 83% [78-87], 87% [83-90], and 92% [88-95], respectively. For thromboembolism, the ICD-9CM codes had the following sensitivity, specificity, positive and negative predictive values: 97% [94-99], 74% [70-79], 62% [57-68], and 98% [96-99], respectively. By selecting a sub-group of ICD-9CM codes for thromboembolism, the positive predictive value increased to 87%. In our centre, the discharge abstract could be used to identify and exclude patients hospitalized with a major bleed or thromboembolism. If coding quality for bleeding is similar in other hospitals, these ICD-9-CM diagnostic codes could be used to study population-based warfarin-associated hemorrhagic complications using administrative databases.


PMID: 16081144

DOI: 10.1016/j.thromres.2005.06.015

Other references

Surono, I.S.; Hosono, A., 1996: Antimutagenicity of milk cultured with lactic acid bacteria from Dadih against mutagenic Terasi. Previous studies indicated that lactic acid bacteria isolated from Dadih, a traditional fermented milk of West Sumatra, Indonesia, have binding abilities towards mutagens as well as inhibitory effects on mutagenic nitrosamines. Furthermore, Terasi...

Mosekilde L.; Mosekilde L.; Danielsen C.C., 1987: Biomechanical competence of vertebral trabecular bone in relation to ash density and age in normal individuals. Cylindrical trabecular bone samples from the central part of the first lumbar vertebral body were obtained from 42 normal people (27 females and 15 males) aged 15-87 years and analyzed by a compression test in either vertical or horizontal directi...

Melo, J.V.; Kumberova, A.; van Dijk, A.G.; Goldman, J.M.; Yuille, M.R., 2001: Investigation on the role of the ATM gene in chronic myeloid leukaemia. Chronic myeloid leukaemia (CML) is characterised by an indolent, chronic phase (CP) preceding an acute transformation to blast crisis (BC). While the BCR-ABL fusion oncogene is strongly implicated in the CP, the molecular changes underlying BC are...

Helms, H.Christian.; Waagepetersen, H.Sønderby.; Nielsen, C.Uhd.; Brodin, B., 2011: Paracellular tightness and claudin-5 expression is increased in the BCEC/astrocyte blood-brain barrier model by increasing media buffer capacity during growth. Most attempts to develop in vitro models of the blood-brain barrier (BBB) have resulted in models with low transendothelial electrical resistances (TEER), as compared to the native endothelium. The aim of the present study was to investigate the i...

Wang, Z.; Zhang, J.; Ye, M.; Zhu, M.; Zhang, B.; Roy, M.; Liu, J.; An, X., 2015: Tumor suppressor role of protein 4.1B/DAL-1. Protein 4.1B/DAL-1 is a membrane skeletal protein that belongs to the protein 4.1 family. Protein 4.1B/DAL-1 is localized to sites of cell-cell contact and functions as an adapter protein, linking the plasma membrane to the cytoskeleton or associa...

Acad Bras Cienc, 1972: Meeting of the academia brasileira de ciencias brazilian academy of sciences rio de janeiro june 30 1972. Anais da Academia Brasileira de Ciencias 44(2): 355-359

Pomper K.W.; Hoover E.E.; Ascher P.D., 1987: Regulation of interspecific seed failure in phaseolus. Hortscience 22(5 SECT 2): 1077

Brotman, A.W., 1991: Combining modalities to treat a young woman with a history of bingeing and purging. Hospital & Community Psychiatry 42(7): 691-692

Robison, G.; Zakharova, T.; Fu, S.; Jiang, W.; Fulper, R.; Barrea, R.; Zheng, W.; Pushkar, Y., 2014: X-ray fluorescence imaging of the hippocampal formation after manganese exposure. Manganese (Mn) intoxication results in neurological conditions similar, but not identical, to idiopathic Parkinson's disease. While the mechanism(s) by which Mn exposure leads to neurotoxic effects remains unclear, studies by magnetic resonan...

Sherwood, M.L.; Buchinsky, F.J.; Quigley, M.R.; Donfack, J.; Choi, S.S.; Conley, S.F.; Derkay, C.S.; Myer, C.M.; Ehrlich, G.D.; Post, J.Christopher., 2006: Unique challenges of obtaining regulatory approval for a multicenter protocol to study the genetics of RRP and suggested remedies. Investigations that seek to generalize findings or to understand uncommon diseases must be conducted at multiple centers. This study describes the process of obtaining regulatory approval for a minimal risk genetic study in a multi-center setting...