Surveillance of Surgery-Related Adverse Events in Missouri Using ICD-9-CM Codes
AGENCY FOR HEALTHCARE RESEARCH AND QUALITY ROCKVILLE MD
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This study estimated the validity of 23 groups of codes in the International Classification of Diseases, 9th revision, Clinical Modification ICD-9-CM or ICD, for flagging adverse events AEs related to hospital surgeries. A set of ICD codes selected as flags for inhospital AEs were developed with the assistance of a national expert panel. The codes were grouped into 66 AE classes, 23 of which were identified as potentially surgery-related. The predictive value positive PVP of the 23 classes was assessed by medical record review of 941 surgical discharges. The 23 classes identified AEs associated with care management during the hospital stay with an average PVP of 45 percent. They identified AEs specifically related to surgery with a PVP of 37 percent. This exploratory study identified a small number of classes and individual ICD codes that identified surgery-related AEs. Further study of selected codes is needed to refine the classes and fully evaluate their use for statewide surveillance of surgery AEs.
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