Missed Registration of Disease Codes for Pediatric Anaphylaxis at the Emergency Department

Background. It is important to register anaphylaxis codes correctly to study the exact prevalence of anaphylaxis. The purpose of this study was to analyze the clinical characteristics and disease codes of inaccurately registered groups in pediatric anaphylaxis patients. Methods. This study reviewed...

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Main Authors: Byungho Choi, Sun Hyu Kim, Hyeji Lee
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Emergency Medicine International
Online Access:http://dx.doi.org/10.1155/2019/4198630
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author Byungho Choi
Sun Hyu Kim
Hyeji Lee
author_facet Byungho Choi
Sun Hyu Kim
Hyeji Lee
author_sort Byungho Choi
collection DOAJ
description Background. It is important to register anaphylaxis codes correctly to study the exact prevalence of anaphylaxis. The purpose of this study was to analyze the clinical characteristics and disease codes of inaccurately registered groups in pediatric anaphylaxis patients. Methods. This study reviewed the medical records of all pediatric patients who presented to the university hospital emergency department over a 5-year period. Study subjects were divided into 2 groups: the accurate group, including those registered under anaphylaxis codes, and the inaccurate coding group, including those registered under other codes. Results. From a total of 79,676 pediatric patients, 184 (0.23%) had anaphylaxis. Of these, 23 (12.5%) and 161 (87.5%) patients were classified to the accurate and inaccurate coding groups, respectively. Average age, time from symptom onset to emergency department presentation, past history of allergy, and penicillin and cephalosporin as causes of anaphylaxis differed between the 2 groups. Cardiovascular (39.1% vs. 5.6%, p=0.001) and respiratory symptoms (65.2% vs. 42.2%, p=0.038) manifested more frequently in the accurate group, while gastrointestinal symptoms (68.3% vs. 26.1%, p=0.001) were more frequently observed in the inaccurate coding group. Fluid administration (82.6% vs. 28.0%, p=0.001), steroid use (60.9% vs. 23.0%, p=0.001), and epinephrine use (65.2% vs. 13.0% p=0.001) were more common treatments for anaphylaxis in the emergency department in the accurate group. Anaphylaxis patients with cardiovascular symptoms, steroid use, and epinephrine use were more likely to be accurately registered with anaphylaxis disease codes. Conclusions. In the case of pediatric anaphylaxis, more patients were registered inaccurately under other allergy-related codes and simple symptom codes, rather than under anaphylaxis codes. Therefore, future research on anaphylaxis should consider inaccurately registered anaphylactic patients, as shown in this study.
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spelling doaj-art-d157a8f834464f5f8cdfbf258a3928342025-02-03T01:23:19ZengWileyEmergency Medicine International2090-28402090-28592019-01-01201910.1155/2019/41986304198630Missed Registration of Disease Codes for Pediatric Anaphylaxis at the Emergency DepartmentByungho Choi0Sun Hyu Kim1Hyeji Lee2Department of Emergency Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan 44033, Republic of KoreaDepartment of Emergency Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan 44033, Republic of KoreaDepartment of Emergency Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan 44033, Republic of KoreaBackground. It is important to register anaphylaxis codes correctly to study the exact prevalence of anaphylaxis. The purpose of this study was to analyze the clinical characteristics and disease codes of inaccurately registered groups in pediatric anaphylaxis patients. Methods. This study reviewed the medical records of all pediatric patients who presented to the university hospital emergency department over a 5-year period. Study subjects were divided into 2 groups: the accurate group, including those registered under anaphylaxis codes, and the inaccurate coding group, including those registered under other codes. Results. From a total of 79,676 pediatric patients, 184 (0.23%) had anaphylaxis. Of these, 23 (12.5%) and 161 (87.5%) patients were classified to the accurate and inaccurate coding groups, respectively. Average age, time from symptom onset to emergency department presentation, past history of allergy, and penicillin and cephalosporin as causes of anaphylaxis differed between the 2 groups. Cardiovascular (39.1% vs. 5.6%, p=0.001) and respiratory symptoms (65.2% vs. 42.2%, p=0.038) manifested more frequently in the accurate group, while gastrointestinal symptoms (68.3% vs. 26.1%, p=0.001) were more frequently observed in the inaccurate coding group. Fluid administration (82.6% vs. 28.0%, p=0.001), steroid use (60.9% vs. 23.0%, p=0.001), and epinephrine use (65.2% vs. 13.0% p=0.001) were more common treatments for anaphylaxis in the emergency department in the accurate group. Anaphylaxis patients with cardiovascular symptoms, steroid use, and epinephrine use were more likely to be accurately registered with anaphylaxis disease codes. Conclusions. In the case of pediatric anaphylaxis, more patients were registered inaccurately under other allergy-related codes and simple symptom codes, rather than under anaphylaxis codes. Therefore, future research on anaphylaxis should consider inaccurately registered anaphylactic patients, as shown in this study.http://dx.doi.org/10.1155/2019/4198630
spellingShingle Byungho Choi
Sun Hyu Kim
Hyeji Lee
Missed Registration of Disease Codes for Pediatric Anaphylaxis at the Emergency Department
Emergency Medicine International
title Missed Registration of Disease Codes for Pediatric Anaphylaxis at the Emergency Department
title_full Missed Registration of Disease Codes for Pediatric Anaphylaxis at the Emergency Department
title_fullStr Missed Registration of Disease Codes for Pediatric Anaphylaxis at the Emergency Department
title_full_unstemmed Missed Registration of Disease Codes for Pediatric Anaphylaxis at the Emergency Department
title_short Missed Registration of Disease Codes for Pediatric Anaphylaxis at the Emergency Department
title_sort missed registration of disease codes for pediatric anaphylaxis at the emergency department
url http://dx.doi.org/10.1155/2019/4198630
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