Validity of an ICD-10 Coding Algorithm for Acute Heat Illness in the Emergency Department: A Retrospective Cohort Study

Acute heat illness (AHI) from extreme environmental heat exposure can lead to emergency department (ED) visits, hospitalization, and even death. While the ICD ninth revision codes for AHI have been validated in the U.S., there have been no studies on the validity of ICD-10 codes for AHI in Canada. T...

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Bibliographic Details
Published in:International journal of environmental research and public health Vol. 21; no. 9; p. 1132
Main Authors: Baassiri, Hasan, Varghese, Timothy, Clemens, Kristin K., Ouédraogo, Alexandra M., Van Aarsen, Kristine, Vujčić, Branka, Yan, Justin W.
Format: Journal Article
Language:English
Published: Switzerland MDPI AG 27.08.2024
MDPI
Subjects:
Adolescent
Adult
Aged
Algorithms
Child
Child, Preschool
Codes
Cohort analysis
Emergency medical care
Emergency Service, Hospital - statistics & numerical data
Fainting
Female
Health sciences
Heat
Heat Stress Disorders - diagnosis
Heat Stress Disorders - epidemiology
Heatstroke
Humans
Illnesses
International Classification of Diseases
London
Male
Medical records
Middle Aged
Patients
Retrospective Studies
Validity
Young Adult
London
Ontario Canada
Canada
United States > US
retrospective cohort study
ICD-10 coding algorithm
acute heat illness
emergency department
ISSN:1660-4601, 1661-7827, 1660-4601
Online Access:Get full text
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Summary:Acute heat illness (AHI) from extreme environmental heat exposure can lead to emergency department (ED) visits, hospitalization, and even death. While the ICD ninth revision codes for AHI have been validated in the U.S., there have been no studies on the validity of ICD-10 codes for AHI in Canada. The objective of this study was to assess the validity of an ICD-10 coding algorithm for ED encounters for AHI. We conducted a retrospective cohort study of children and adults who had ED encounters at two large academic, tertiary hospitals in London, Canada, between May and September 2014–2018. We developed an algorithm of ICD-10 codes for AHI based upon a literature review and clinical expertise. Our “gold-standard” definition of AHI was patient-reported heat exposure and documentation of at least one heat-related complaint. To establish positive predictive value (PPV), we reviewed 62 algorithm-positive records and noted which met our “gold-standard” definition. To calculate negative predictive value (NPV), sensitivity (Sn), and specificity (Sp), we randomly reviewed 964 ED records for associated ICD-10 codes and diagnoses. Two independent reviewers completed blinded data abstraction, with duplicate abstraction in 20% of the sample. Of the 62 algorithm-positive records, mean (SD) age was 38.8 (23.8) years; 37% were female. PPV was 61.3 ± 12.1% (95% CI). Of the 964 randomly selected records, mean (SD) age was 41.7 (26.5) years; 51.1% were female. The NPV was 99.7 ± 0.4%, sensitivity 25.0 ± 42.4%, and specificity 100.0 ± 0.0%. An ICD-10 coding algorithm for AHI had high specificity but was limited in sensitivity. This algorithm can be used to assemble and study cohorts of patients who have had an AHI, but may underestimate the true incidence of AHI presentations in the ED.
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ISSN:1660-4601
1661-7827
1660-4601
DOI:10.3390/ijerph21091132