Accuracy of ICD-9 codes in identifying ischemic stroke in the General Hospital of Lugo di Romagna (Italy)

R. Rinaldi, L. Vignatelli, M. Galeotti, G. Azzimondi, P. de Carolis

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

We assessed the sensitivity and the positive predictive value (PPV) of the ICD-9 codes in identifying ischemic strokes. The study involved the cross-sectional comparison between patients with an ischemic stroke diagnosis made by neurologists and patients with the 434 or 436 discharge codes. Sensitivity of the codes (all diagnostic levels and first level respectively) was 82% and 76%; PPV: 71% and 76%. The annual crude incidence of ischemic stroke was 2.62 per 1000 based on verified strokes and 3.03 per 1000 based on 434 or 436 coded medical records (at all diagnostic levels). Thirty-day case fatality ratio was 22.3% in verified strokes and 36.8% among patients diagnosed with codes 434 or 436 but without stroke (all levels). Our results disclosed inaccuracy in use of the ICD-9 codes in the diagnosis of ischemic stroke in the general hospital of Lugo di Romagna, Ravenna Province, Italy. The misdiagnosis of patients could be influenced by the degree of severity of clinical features. Epidemiological data and cost-analysis forecasts based only on the ICD-9 system must be considered with caution.

Original languageEnglish
Pages (from-to)65-69
Number of pages5
JournalNeurological Sciences
Volume24
Issue number2
Publication statusPublished - Jun 2003

Fingerprint

International Classification of Diseases
General Hospitals
Italy
Stroke
Diagnostic Errors
Medical Records
Cross-Sectional Studies
Costs and Cost Analysis
Incidence

Keywords

  • Case-fatality ratio
  • ICD-9
  • Incidence
  • Ischemic stroke
  • Positive predictive value
  • Sensitivity

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Rinaldi, R., Vignatelli, L., Galeotti, M., Azzimondi, G., & de Carolis, P. (2003). Accuracy of ICD-9 codes in identifying ischemic stroke in the General Hospital of Lugo di Romagna (Italy). Neurological Sciences, 24(2), 65-69.

Accuracy of ICD-9 codes in identifying ischemic stroke in the General Hospital of Lugo di Romagna (Italy). / Rinaldi, R.; Vignatelli, L.; Galeotti, M.; Azzimondi, G.; de Carolis, P.

In: Neurological Sciences, Vol. 24, No. 2, 06.2003, p. 65-69.

Research output: Contribution to journalArticle

Rinaldi, R, Vignatelli, L, Galeotti, M, Azzimondi, G & de Carolis, P 2003, 'Accuracy of ICD-9 codes in identifying ischemic stroke in the General Hospital of Lugo di Romagna (Italy)', Neurological Sciences, vol. 24, no. 2, pp. 65-69.
Rinaldi R, Vignatelli L, Galeotti M, Azzimondi G, de Carolis P. Accuracy of ICD-9 codes in identifying ischemic stroke in the General Hospital of Lugo di Romagna (Italy). Neurological Sciences. 2003 Jun;24(2):65-69.
Rinaldi, R. ; Vignatelli, L. ; Galeotti, M. ; Azzimondi, G. ; de Carolis, P. / Accuracy of ICD-9 codes in identifying ischemic stroke in the General Hospital of Lugo di Romagna (Italy). In: Neurological Sciences. 2003 ; Vol. 24, No. 2. pp. 65-69.
@article{90ecf7b358244c679170753387af0b41,
title = "Accuracy of ICD-9 codes in identifying ischemic stroke in the General Hospital of Lugo di Romagna (Italy)",
abstract = "We assessed the sensitivity and the positive predictive value (PPV) of the ICD-9 codes in identifying ischemic strokes. The study involved the cross-sectional comparison between patients with an ischemic stroke diagnosis made by neurologists and patients with the 434 or 436 discharge codes. Sensitivity of the codes (all diagnostic levels and first level respectively) was 82{\%} and 76{\%}; PPV: 71{\%} and 76{\%}. The annual crude incidence of ischemic stroke was 2.62 per 1000 based on verified strokes and 3.03 per 1000 based on 434 or 436 coded medical records (at all diagnostic levels). Thirty-day case fatality ratio was 22.3{\%} in verified strokes and 36.8{\%} among patients diagnosed with codes 434 or 436 but without stroke (all levels). Our results disclosed inaccuracy in use of the ICD-9 codes in the diagnosis of ischemic stroke in the general hospital of Lugo di Romagna, Ravenna Province, Italy. The misdiagnosis of patients could be influenced by the degree of severity of clinical features. Epidemiological data and cost-analysis forecasts based only on the ICD-9 system must be considered with caution.",
keywords = "Case-fatality ratio, ICD-9, Incidence, Ischemic stroke, Positive predictive value, Sensitivity",
author = "R. Rinaldi and L. Vignatelli and M. Galeotti and G. Azzimondi and {de Carolis}, P.",
year = "2003",
month = "6",
language = "English",
volume = "24",
pages = "65--69",
journal = "Neurological Sciences",
issn = "1590-1874",
publisher = "Springer-Verlag Italia s.r.l.",
number = "2",

}

TY - JOUR

T1 - Accuracy of ICD-9 codes in identifying ischemic stroke in the General Hospital of Lugo di Romagna (Italy)

AU - Rinaldi, R.

AU - Vignatelli, L.

AU - Galeotti, M.

AU - Azzimondi, G.

AU - de Carolis, P.

PY - 2003/6

Y1 - 2003/6

N2 - We assessed the sensitivity and the positive predictive value (PPV) of the ICD-9 codes in identifying ischemic strokes. The study involved the cross-sectional comparison between patients with an ischemic stroke diagnosis made by neurologists and patients with the 434 or 436 discharge codes. Sensitivity of the codes (all diagnostic levels and first level respectively) was 82% and 76%; PPV: 71% and 76%. The annual crude incidence of ischemic stroke was 2.62 per 1000 based on verified strokes and 3.03 per 1000 based on 434 or 436 coded medical records (at all diagnostic levels). Thirty-day case fatality ratio was 22.3% in verified strokes and 36.8% among patients diagnosed with codes 434 or 436 but without stroke (all levels). Our results disclosed inaccuracy in use of the ICD-9 codes in the diagnosis of ischemic stroke in the general hospital of Lugo di Romagna, Ravenna Province, Italy. The misdiagnosis of patients could be influenced by the degree of severity of clinical features. Epidemiological data and cost-analysis forecasts based only on the ICD-9 system must be considered with caution.

AB - We assessed the sensitivity and the positive predictive value (PPV) of the ICD-9 codes in identifying ischemic strokes. The study involved the cross-sectional comparison between patients with an ischemic stroke diagnosis made by neurologists and patients with the 434 or 436 discharge codes. Sensitivity of the codes (all diagnostic levels and first level respectively) was 82% and 76%; PPV: 71% and 76%. The annual crude incidence of ischemic stroke was 2.62 per 1000 based on verified strokes and 3.03 per 1000 based on 434 or 436 coded medical records (at all diagnostic levels). Thirty-day case fatality ratio was 22.3% in verified strokes and 36.8% among patients diagnosed with codes 434 or 436 but without stroke (all levels). Our results disclosed inaccuracy in use of the ICD-9 codes in the diagnosis of ischemic stroke in the general hospital of Lugo di Romagna, Ravenna Province, Italy. The misdiagnosis of patients could be influenced by the degree of severity of clinical features. Epidemiological data and cost-analysis forecasts based only on the ICD-9 system must be considered with caution.

KW - Case-fatality ratio

KW - ICD-9

KW - Incidence

KW - Ischemic stroke

KW - Positive predictive value

KW - Sensitivity

UR - http://www.scopus.com/inward/record.url?scp=0037745736&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037745736&partnerID=8YFLogxK

M3 - Article

C2 - 12827541

AN - SCOPUS:0037745736

VL - 24

SP - 65

EP - 69

JO - Neurological Sciences

JF - Neurological Sciences

SN - 1590-1874

IS - 2

ER -