ICD-10 hospital discharge diagnosis codes were sensitive for identifying pulmonary embolism but not deep vein thrombosis.
OBJECTIVE
To estimate the sensitivity of International Classification of Diseases, Tenth revision (ICD-10) hospital discharge diagnosis codes for identifying deep vein thrombosis (DVT) and pulmonary embolism (PE).


METHODS
We compared predefined ICD-10 discharge diagnosis codes with the diagnoses that were prospectively recorded for 1,375 patients with suspected DVT or PE who were enrolled at 25 hospitals in France. Sensitivity was calculated as the percentage of patients identified by predefined ICD-10 codes among positive cases of acute symptomatic DVT or PE confirmed by objective testing.


RESULTS
The sensitivity of ICD-10 codes was 58.0% (159 of 274; 95% CI: 51.9, 64.1) for isolated DVT and 88.9% (297 of 334; 95% CI: 85.6, 92.2) for PE. Depending on the hospital, the median values for sensitivity were 57.7% for DVT (interquartile range, IQR, 48.6-66.7; intracluster correlation coefficient, 0.02; P=0.31) and 88.9% for PE (IQR, 83.3-96.3; intracluster correlation coefficient, 0.11; P=0.03). The sensitivity of ICD-10 codes was lower for surgical patients and for patients who developed PE or DVT while they were hospitalized.


CONCLUSIONS
ICD-10 discharge diagnosis codes yield satisfactory sensitivity for identifying objectively confirmed PE. A substantial proportion of DVT cases are missed when using hospital discharge data for complication screening or research purposes.
Casez
Pierre
P
Techniques de l'Ingénierie Médicale et de la Complexité (TIMC), Unité Mixte de Recherche 5525, Centre National de la Recherche Scientifique (CNRS) Université Joseph Fourier, Grenoble, France.
Labarère
José
J
Sevestre
Marie-Antoinette
MA
Haddouche
Myriam
M
Courtois
Xavier
X
Mercier
Sandrine
S
Lewandowski
Elisabeth
E
Fauconnier
Jérôme
J
François
Patrice
P
Bosson
Jean-Luc
JL
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010351:Patient Discharge; D011655:Pulmonary Embolism / Q000145:classification / Q000175:diagnosis*; D011785:Quality Assurance, Health Care / Q000379:methods; D012680:Sensitivity and Specificity; D020246:Venous Thrombosis / Q000145:classification / Q000175:diagnosis*