Document Type
Article
Publication Date
4-1-2018
Abstract
AIM: International classification of disease (ICD-9) code 427.5 (cardiac arrest) is utilized to identify cohorts of patients who suffer out-of-hospital cardiac arrest (OHCA), though the use of ICD codes for this purpose has never been formally validated. We sought to validate the utility of ICD-9 code 427.5 by identifying patients admitted from the emergency department (ED) after OHCA.
METHODS: Adult visits to a single ED between January 2007 and July 2012 were retrospectively examined and a keyword search of the electronic medical record (EMR) was used to identify patients. Cardiac arrest was confirmed; and ICD-9 information and location of return of spontaneous circulation (ROSC) were collected. Separately, the EMR was searched for patients who received ICD-9 code 427.5. The kappa coefficient (κ) was calculated, as was the sensitivity and specificity of the code for identifying OHCA.
RESULTS: The keyword search identified 1717 patients, of which 385 suffered OHCA and 333 were assigned the code 427.5. The agreement between ICD-9 code and cardiac arrest was excellent (κ = 0.895). The ICD-9 code 427.5 was both specific (99.4%) and sensitive (86.5%). Of the 52 cardiac arrests that were not identified by ICD-9 code, 33% had ROSC before arrival to the ED. When searching independently on ICD-9 code, 347 patients with ICD-9 code 427.5 were found, of which 320 were "true" arrests. This yielded a positive predictive value of 92% for ICD-9 code 427.5 in predicting OHCA.
CONCLUSIONS: ICD-9 code 427.5 is sensitive and specific for identifying ED patients who suffer OHCA with a positive predictive value of 92%.
Recommended Citation
Shelton, Shelby K.; Chukwulebe, Steve B.; Gaieski, David F.; Abella, Benjamin S.; Carr, Brendan G.; and Perman, Sarah M., "Validation of an ICD code for accurately identifying emergency department patients who suffer an out-of-hospital cardiac arrest." (2018). Department of Emergency Medicine Faculty Papers. Paper 110.
https://jdc.jefferson.edu/emfp/110
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
PubMed ID
29341874
Language
English
Comments
This article is the authors' final version prior to publication in Resuscitation, Volume 125, April 2018, Pages 8-11.
The published version is available at https://doi.org/10.1016/j.resuscitation.2018.01.021. Copyright © Shelton et al.