title: Case definitions for acute myocardial infarction in administrative databases and their impact on in-hospital mortality rates.
abstract: OBJECTIVE
  To identify validated ICD-9-CM/ICD-10 coded case definitions for acute myocardial infarction (AMI).
  
  
  METHODS
  Ovid Medline (1950-2010) was searched to identify studies that validated acute myocardial infarction (AMI) case definitions. Hospital discharge abstract data and chart data were linked to validate identified AMI definitions.
  
  
  METHODS
  Systematic literature review, chart review, and administrative data analysis.
  
  
  METHODS
  Data on sensitivity/specificity/positive and negative predictive values (PPV and NPV) were extracted from previous studies to identify validated case definitions for AMI. These case definitions were validated in administrative data through chart review and applied to hospital discharge data to assess in-hospital mortality.
  
  
  RESULTS
  Of the eight ICD-9-CM definitions validated in the literature, use of ICD-9-CM code 410 to define AMI had the highest sensitivity (94 percent) and specificity (99 percent). In our data, ICD-9-CM/ICD-10 codes 410/I21-I22 in all available coding fields had high sensitivity (83.3 percent/82.8 percent) and PPV (82.8 percent/82.2 percent). The in-hospital mortality among AMI patients identified using this case definition was 7.6 percent in ICD-9-CM data and 6.6 percent in ICD-10 data.
  
  
  CONCLUSIONS
  We recommend that ICD-9-CM 410 or ICD-10 I21-I22 in the primary diagnosis coding field should be used to define AMI. The use of a consistent validated case definition would improve comparability across studies.
authors: Departments of Community Health Sciences and Clinical Neurosciences, University of Calgary, TRW Building 3rd Floor, 3280 Hospital Drive NW, Calgary, AB, Canada, T2N 4Z6. amy.metcalfe@albertahealthservices.ca
authors: Amy
authors: A
authors: Metcalfe
authors: Annabelle
authors: A
authors: Neudam
authors: Samantha
authors: S
authors: Forde
authors: Mingfu
authors: M
authors: Liu
authors: Saskia
authors: S
authors: Drosler
authors: Hude
authors: H
authors: Quan
authors: Nathalie
authors: N
authors: Jetté
mesh_terms: D000208:Acute Disease; D016208:Databases, Factual / Q000706:statistics & numerical data; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D038801:International Classification of Diseases / Q000706:statistics & numerical data*; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000401:mortality*; D010351:Patient Discharge / Q000706:statistics & numerical data; D015203:Reproducibility of Results