Dataset Information

Validation of the International Classification of Disease 10th Revision Codes for Kidney Transplant Rejection and Failure.

ABSTRACT:

Background

Clinical research requires that diagnostic codes captured from routinely collected health administrative data accurately identify individuals with a disease.

Objective

In this study, we validated the International Classification of Disease 10th Revision (ICD-10) definition for kidney transplant rejection (T86.100) and for kidney transplant failure (T86.101).

Design

Retrospective cohort study.

Setting

A large, regional transplantation center in Ontario, Canada.

Patients

All adult kidney transplant recipients from 2002 to 2018.

Measurements

Chart review was undertaken to identify the first occurrence of biopsy-confirmed rejection and graft loss for all participants. For each observation, we determined the first date a single ICD-10 code T86.100 or T86.101 was recorded as a hospital encounter discharge diagnosis.

Methods

Using chart review as the gold standard, we determined the sensitivity, specificity, and positive predictive value (PPV) for the ICD-10 codes T86.100 and T86.101.

Results

Our study population comprised of 1,258 kidney transplant recipients. The prevalence of rejection and death-censored graft loss were 15.6 and 9.1%, respectively. For the ICD-10 rejection code (T86.100), sensitivity was 72.9% (95% confidence interval [CI], 66.6-79.2), specificity 97.5% (96.5-98.4), and PPV 83.8% (78.3-89.4). For the ICD-10 graft loss code (T86.101), sensitivity was 21.2% (95% CI, 13.2-29.3), specificity 86.3% (84.3-88.3), and PPV 11.7% (7.0-16.4).

Limitations

Single-center study which may limit generalizability of our findings.

Conclusions

A single ICD-10 code for kidney transplant rejection (T86.100) was present in 84% of true kidney transplant rejections and is an accurate way of identifying kidney transplant recipients with rejection using administrative health data. The ICD-10 code for graft failure (T86.101) performed poorly and should not be used for administrative health research.

SUBMITTER: Massicotte-Azarniouch D

PROVIDER: S-EPMC7747098 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Validation of the International Classification of Disease 10th Revision Codes for Kidney Transplant Rejection and Failure.

Massicotte-Azarniouch David D Sood Manish M MM Fergusson Dean A DA Knoll Greg A GA

Canadian journal of kidney health and disease 20201216

<h4>Background</h4>Clinical research requires that diagnostic codes captured from routinely collected health administrative data accurately identify individuals with a disease.<h4>Objective</h4>In this study, we validated the International Classification of Disease 10th Revision (ICD-10) definition for kidney transplant rejection (T86.100) and for kidney transplant failure (T86.101).<h4>Design</h4>Retrospective cohort study.<h4>Setting</h4>A large, regional transplantation center in Ontario, Can ...[more]

PMID: 33403117

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Project description:To examine the validity of the International Classification of Diseases, 10th revision (ICD-10) codes for hyponatraemia in the nationwide population-based Danish National Registry of Patients (DNRP) among inpatients of all ages.Population-based validation study.All somatic hospitals in the North and Central Denmark Regions from 2006 through 2011.Patients of all ages admitted to hospital (n=819 701 individual patients) during the study period. The patient could be included in the study more than once, and our study did not restrict to patients with serum sodium measurements (total of n=2 186 642 hospitalisations).We validated ICD-10 discharge diagnoses of hyponatraemia recorded in the DNRP, using serum sodium measurements obtained from the laboratory information systems (LABKA) research database as the gold standard. One sodium value <135 mmol/L measured at any time during hospitalisation confirmed the diagnosis. We estimated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for ICD-10 codes for hyponatraemia overall and for cut-off points for increasing hyponatraemia severity.An ICD-10 code for hyponatraemia was recorded in the DNRP in 5850 of the 2 186 642 hospitalisations identified. According to laboratory measurements, however, hyponatraemia was present in 306 418 (14%) hospitalisations. Sensitivity of hyponatraemia diagnoses was 1.8% (95% CI 1.7% to 1.8%). For sodium values <115 mmol/L, sensitivity was 34.3% (95% CI 32.6% to 35.9%). The overall PPV was 92.5% (95% CI 91.8% to 93.1%) and decreased with increasing hyponatraemia severity. Specificity and NPV were high for all cut-off points (?99.8% and ?86.2%, respectively). Patients with hyponatraemia without a corresponding ICD-10 discharge diagnosis were younger and had higher Charlson Comorbidity Index scores than patients with hyponatraemia with a hyponatraemia code in the DNRP.ICD-10 codes for hyponatraemia in the DNRP have high specificity but very low sensitivity. Laboratory test results, not discharge diagnoses, should be used to ascertain hyponatraemia.

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Dataset Information

Validation of the International Classification of Disease 10th Revision Codes for Kidney Transplant Rejection and Failure.

Background

Objective

Design

Setting

Patients

Measurements

Methods

Results

Limitations

Conclusions

Publications

Validation of the International Classification of Disease 10th Revision Codes for Kidney Transplant Rejection and Failure.

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