Validity of the International Classification of Diseases 10th revision code for hospitalisation with hyponatraemia in elderly patients
Objective To evaluate the validity of the International Classification of Diseases, 10th Revision (ICD-10) diagnosis code for hyponatraemia (E87.1) in two settings: at presentation to the emergency department and at hospital admission.Design Population-based retrospective validation study.Setting Tw...
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BMJ Publishing Group
2012-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/2/6/e001727.full |
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| author | Amit X Garg Salimah Z Shariff Sonja Gandhi Jamie L Fleet Matthew A Weir Arsh K Jain |
| author_facet | Amit X Garg Salimah Z Shariff Sonja Gandhi Jamie L Fleet Matthew A Weir Arsh K Jain |
| author_sort | Amit X Garg |
| collection | DOAJ |
| description | Objective To evaluate the validity of the International Classification of Diseases, 10th Revision (ICD-10) diagnosis code for hyponatraemia (E87.1) in two settings: at presentation to the emergency department and at hospital admission.Design Population-based retrospective validation study.Setting Twelve hospitals in Southwestern Ontario, Canada, from 2003 to 2010.Participants Patients aged 66 years and older with serum sodium laboratory measurements at presentation to the emergency department (n=64 581) and at hospital admission (n=64 499).Main outcome measures Sensitivity, specificity, positive predictive value and negative predictive value comparing various ICD-10 diagnostic coding algorithms for hyponatraemia to serum sodium laboratory measurements (reference standard). Median serum sodium values comparing patients who were code positive and code negative for hyponatraemia.Results The sensitivity of hyponatraemia (defined by a serum sodium ≤132 mmol/l) for the best-performing ICD-10 coding algorithm was 7.5% at presentation to the emergency department (95% CI 7.0% to 8.2%) and 10.6% at hospital admission (95% CI 9.9% to 11.2%). Both specificities were greater than 99%. In the two settings, the positive predictive values were 96.4% (95% CI 94.6% to 97.6%) and 82.3% (95% CI 80.0% to 84.4%), while the negative predictive values were 89.2% (95% CI 89.0% to 89.5%) and 87.1% (95% CI 86.8% to 87.4%). In patients who were code positive for hyponatraemia, the median (IQR) serum sodium measurements were 123 (119–126) mmol/l and 125 (120–130) mmol/l in the two settings. In code negative patients, the measurements were 138 (136–140) mmol/l and 137 (135–139) mmol/l.Conclusions The ICD-10 diagnostic code for hyponatraemia differentiates between two groups of patients with distinct serum sodium measurements at both presentation to the emergency department and at hospital admission. However, these codes underestimate the true incidence of hyponatraemia due to low sensitivity. |
| format | Article |
| id | doaj-art-a3a3f40af56b476fb155876abb34ff33 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2012-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-a3a3f40af56b476fb155876abb34ff332025-08-20T03:53:01ZengBMJ Publishing GroupBMJ Open2044-60552012-12-012610.1136/bmjopen-2012-001727Validity of the International Classification of Diseases 10th revision code for hospitalisation with hyponatraemia in elderly patientsAmit X Garg0Salimah Z Shariff1Sonja Gandhi2Jamie L Fleet3Matthew A Weir4Arsh K Jain52 Institute for Clinical Evaluative Sciences, Ontario, CanadaICES Western, Toronto, Ontario, Canada1Division of Nephrology, Department of Medicine, Western University, London, Ontario, Canada1Division of Nephrology, Department of Medicine, Western University, London, Ontario, Canada1Division of Nephrology, Department of Medicine, Western University, London, Ontario, Canada1Division of Nephrology, Department of Medicine, Western University, London, Ontario, CanadaObjective To evaluate the validity of the International Classification of Diseases, 10th Revision (ICD-10) diagnosis code for hyponatraemia (E87.1) in two settings: at presentation to the emergency department and at hospital admission.Design Population-based retrospective validation study.Setting Twelve hospitals in Southwestern Ontario, Canada, from 2003 to 2010.Participants Patients aged 66 years and older with serum sodium laboratory measurements at presentation to the emergency department (n=64 581) and at hospital admission (n=64 499).Main outcome measures Sensitivity, specificity, positive predictive value and negative predictive value comparing various ICD-10 diagnostic coding algorithms for hyponatraemia to serum sodium laboratory measurements (reference standard). Median serum sodium values comparing patients who were code positive and code negative for hyponatraemia.Results The sensitivity of hyponatraemia (defined by a serum sodium ≤132 mmol/l) for the best-performing ICD-10 coding algorithm was 7.5% at presentation to the emergency department (95% CI 7.0% to 8.2%) and 10.6% at hospital admission (95% CI 9.9% to 11.2%). Both specificities were greater than 99%. In the two settings, the positive predictive values were 96.4% (95% CI 94.6% to 97.6%) and 82.3% (95% CI 80.0% to 84.4%), while the negative predictive values were 89.2% (95% CI 89.0% to 89.5%) and 87.1% (95% CI 86.8% to 87.4%). In patients who were code positive for hyponatraemia, the median (IQR) serum sodium measurements were 123 (119–126) mmol/l and 125 (120–130) mmol/l in the two settings. In code negative patients, the measurements were 138 (136–140) mmol/l and 137 (135–139) mmol/l.Conclusions The ICD-10 diagnostic code for hyponatraemia differentiates between two groups of patients with distinct serum sodium measurements at both presentation to the emergency department and at hospital admission. However, these codes underestimate the true incidence of hyponatraemia due to low sensitivity.https://bmjopen.bmj.com/content/2/6/e001727.full |
| spellingShingle | Amit X Garg Salimah Z Shariff Sonja Gandhi Jamie L Fleet Matthew A Weir Arsh K Jain Validity of the International Classification of Diseases 10th revision code for hospitalisation with hyponatraemia in elderly patients BMJ Open |
| title | Validity of the International Classification of Diseases 10th revision code for hospitalisation with hyponatraemia in elderly patients |
| title_full | Validity of the International Classification of Diseases 10th revision code for hospitalisation with hyponatraemia in elderly patients |
| title_fullStr | Validity of the International Classification of Diseases 10th revision code for hospitalisation with hyponatraemia in elderly patients |
| title_full_unstemmed | Validity of the International Classification of Diseases 10th revision code for hospitalisation with hyponatraemia in elderly patients |
| title_short | Validity of the International Classification of Diseases 10th revision code for hospitalisation with hyponatraemia in elderly patients |
| title_sort | validity of the international classification of diseases 10th revision code for hospitalisation with hyponatraemia in elderly patients |
| url | https://bmjopen.bmj.com/content/2/6/e001727.full |
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