Surveillance of Surgery-Related Adverse Events in Missouri Using ICD-9-CM Codes

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...

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Bibliographic Details
Main Authors: Van Tuinen, Mark, Elder, Susan, Link, Carolyn, Li, Susan, Song, John H, Pritchett, Tracey
Format: Report
Language:English
Subjects:
ADVERSE EVENTS
ADVERSE SURGICAL EVENTS
CARE MANAGEMENT
CLASSIFICATION
CLINICAL MEDICINE
DISEASES
ERRORS
HOSPITALIZATIONS
ICD CODES
ICD-9-CM CODES
IDENTIFICATION
Information Science
INTERNATIONAL CLASSIFICATION OF DISEASES 9TH REVISION
MEDICAL ERRORS
MEDICAL RECORD ABSTRACTION
MEDICAL RESEARCH
Medicine and Medical Research
MONITORING
PATIENT CARE
PATIENT SAFETY REPORTING
PATIENTS
PREDICTIONS
SIGNS AND SYMPTOMS
SURGERY
SURVEILLANCE
TOTAL QUALITY MANAGEMENT
VALIDATION
WOUNDS AND INJURIES
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Summary: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. Published in Advances in Patient Safety: From Research to Implementation, v1 p245-257, AHRQ Publication Nos. 050021 (1-4), Feb 2005.