Validity of International Classification of Diseases, Ninth Revision, Clinical Modification Codes for Acute Renal Failure.
Administrative and claims databases may be useful for the study of acute renal failure (ARF) and ARF that requires dialysis (ARF-D), but the validity of the corresponding diagnosis and procedure codes is unknown. The performance characteristics of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for ARF were assessed against serum creatinine-based definitions of ARF in 97,705 adult discharges from three Boston hospitals in 2004. For ARF-D, ICD-9-CM codes were compared with review of medical records in 150 patients with ARF-D and 150 control patients. As compared with a diagnostic standard of a 100% change in serum creatinine, ICD-9-CM codes for ARF had a sensitivity of 35.4%, specificity of 97.7%, positive predictive value of 47.9%, and negative predictive value of 96.1%. As compared with review of medical records, ICD-9-CM codes for ARF-D had positive predictive value of 94.0% and negative predictive value of 90.0%. It is concluded that administrative databases may be a powerful tool for the study of ARF, although the low sensitivity of ARF codes is an important caveat. The excellent performance characteristics of ICD-9-CM codes for ARF-D suggest that administrative data sets may be particularly well suited for research endeavors that involve patients with ARF-D.
Waikar
Sushrut S
SS
Renal Division and Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. swaikar@partners.org
Wald
Ron
R
Chertow
Glenn M
GM
Curhan
Gary C
GC
Winkelmayer
Wolfgang C
WC
Liangos
Orfeas
O
Sosa
Marie-Anne
MA
Jaber
Bertrand L
BL
D058186:Acute Kidney Injury / Q000145:classification* / Q000175:diagnosis; D000368:Aged; D003953:Diagnosis-Related Groups; D005260:Female; D005568:Forms and Records Control; D006753:Hospital Records; D006801:Humans; D007344:Insurance Claim Reporting; D038801:International Classification of Diseases; D039703:Logical Observation Identifiers Names and Codes; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D015233:Models, Statistical; D012189:Retrospective Studies