ABSTRACT

Objective: Using inpatient data from a 1,160-bed health system, we assessed the positive predictive value (PPV) of ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification) codes included in a traumatic brain injury (TBI) surveillance definition proposed by the Centers for Disease Control and Prevention (CDC) in 2016.

Methods: A random sample of 196 records with ICD-10-CM TBI codes was reviewed. The PPVs for the ICD-10-CM codes’ ability to capture true TBI cases were calculated as the percentage of records with confirmed clinical provider-documented TBI and reported with 95% confidence intervals [95%CIs].

Results: The estimated overall PPV was 74% [67.9%, 80.1%] when the codes were listed in any diagnostic field, but 91.5% [86.2%, 96.8%] when listed as the principal diagnosis. S06 codes (intracranial injury) had an overall PPV of 80.2% [74.3%, 86.1%] and 96.9% [93.3%, 100%] when listed as the principal diagnosis. S02.0-.1 codes (vault/base skull fractures) in any position without co-existing S06 codes had a PPV of 15.8% [0%, 33.2%].

Conclusions: Intracranial injury codes (S06) in any diagnostic position had a very high estimated PPV. Further research is needed to determine the utility of other codes included in the CDC proposed definition for TBI surveillance.

 抽象的

目的：利用来自 1,160 个床位的卫生系统的住院患者数据，我们评估了创伤性脑损伤 (TBI) 中包含的 ICD-10-CM（国际疾病分类，第十次修订版，临床修改）代码的阳性预测值 (PPV)美国疾病控制与预防中心 (CDC) 于 2016 年提出的监测定义。

方法：随机抽取 196 份带有 ICD-10-CM TBI 代码的记录进行审查。 ICD-10-CM 代码捕获真实 TBI 病例的能力的 PPV 计算为已确认的临床提供者记录的 TBI 记录的百分比，并以 95% 置信区间 [95%CI] 报告。

结果：当代码列在任何诊断领域时，估计的总体 PPV 为 74% [67.9%, 80.1%]，但当列为主要诊断时，估计总体 PPV 为 91.5% [86.2%, 96.8%]。当列为主要诊断时，S06 代码（颅内损伤）的总体 PPV 为 80.2% [74.3%, 86.1%] 和 96.9% [93.3%, 100%]。没有共存 S06 代码的任何位置的 S02.0-.1 代码（穹窿/颅底骨折）的 PPV 为 15.8% [0%, 33.2%]。

结论：任何诊断位置的颅内损伤代码 (S06) 都有非常高的估计 PPV。需要进一步研究来确定 CDC 提议的 TBI 监测定义中包含的其他代码的效用。