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Validity of ICD-10 codes for COVID-19 patients with hospital admissions or ED visits in Canada: a retrospective cohort study.


ABSTRACT:

Objective

To evaluate the validity of COVID-19 International Classification of Diseases, 10th Revision (ICD-10) codes and their combinations.

Design

Retrospective cohort study.

Setting

Acute care hospitals and emergency departments (EDs) in Alberta, Canada.

Participants

Patients who were admitted to hospital or presented to an ED in Alberta, as captured by local administrative databases between 1 March 2020 and 28 February 2021, who had a positive COVID-19 test and/or a COVID-19-related ICD-10 code.

Main outcome measures

The sensitivity, positive predictive value (PPV) and 95% CIs for ICD-10 codes were computed. Stratified analysis on age group, sex, symptomatic status, mechanical ventilation, hospital type, patient intensive care unit (ICU) admission, discharge status and season of pandemic were conducted.

Results

Two overlapping subsets of the study population were considered: those who had a positive COVID-19 test (cohort A, for estimating sensitivity) and those who had a COVID-19-related ICD-10 code (cohort B, for estimating PPV). Cohort A included 17 979 ED patients and 6477 inpatients while cohort B included 33 675 ED patients and 18 746 inpatients. Of inpatients, 9.5% in cohort A and 8.1% in cohort B received mechanical ventilation. Over 13% of inpatients were admitted to ICU. The length of hospital stay was 6 days (IQR: 3-14) for cohort A and 8 days (IQR: 3-19) for cohort B. In-hospital mortality was 15.9% and 38.8% for cohort A and B, respectively. The sensitivity for ICD-10 code U07.1 (COVID-19, virus identified) was 82.5% (81.8%-83.2%) with a PPV of 93.1% (92.6%-93.6%). The combination of U07.1 and U07.3 (multisystem inflammatory syndrome associated with COVID-19) had a sensitivity of 82.5% (81.9%-83.2%) and PPV of 92.9% (92.4%-93.4%).

Conclusions

In Alberta, ICD-10 COVID-19 codes (U07.1 and U07.3) were coded well with high validity. This indicates administrative data can be used for COVID-19 research and pandemic management purposes.

SUBMITTER: Wu G 

PROVIDER: S-EPMC8787827 | biostudies-literature |

REPOSITORIES: biostudies-literature

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