title: Exploring in-hospital adverse drug events using ICD-10 codes.
abstract: OBJECTIVE
  Adverse drug events (ADEs) during hospital admissions are a widespread problem associated with adverse patient outcomes. The 'external cause' codes in the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) provide opportunities for identifying the incidence of ADEs acquired during hospital stays that may assist in targeting interventions to decrease their occurrence. The aim of the present study was to use routine administrative data to identify ADEs acquired during hospital admissions in a suburban healthcare network in Melbourne, Australia.
  
  
  METHODS
  Thirty-nine secondary diagnosis fields of hospital discharge data for a 1-year period were reviewed for 'diagnoses not present on admission' and assigned to the Classification of Hospital Acquired Diagnoses (CHADx) subclasses. Discharges with one or more ADE subclass were extracted for retrospective analysis.
  
  
  RESULTS
  From 57205 hospital discharges, 7891 discharges (13.8%) had at least one CHADx, and 402 discharges (0.7%) had an ADE recorded. The highest proportion of ADEs was due to administration of analgesics (27%) and systemic antibiotics (23%). Other major contributors were anticoagulation (13%), anaesthesia (9%) and medications with cardiovascular side-effects (9%).
  
  
  CONCLUSIONS
  Hospital data coded in ICD-10 can be used to identify ADEs that occur during hospital stays and also clinical conditions, therapeutic drug classes and treating units where these occur. Using the CHADx algorithm on administrative datasets provides a consistent and economical method for such ADE monitoring.
authors.affiliation: Northern Clinical Research Centre, Northern Health, 185 Cooper Street, Epping, Vic. 3076, Australia. Email:
authors.forename: Sumit
authors.initials: S
authors.lastname: Parikh
authors.affiliation: Quality, Safety and Risk Management Unit, Northern Health, 185 Cooper Street, Epping, Vic. 3076, Australia. Email: ;
authors.forename: Donna
authors.initials: D
authors.lastname: Christensen
authors.affiliation: Pharmacy Services, Northern Health, 185 Cooper Street, Epping, Vic. 3076, Australia. Email:
authors.forename: Peter
authors.initials: P
authors.lastname: Stuchbery
authors.affiliation: Quality, Safety and Risk Management Unit, Northern Health, 185 Cooper Street, Epping, Vic. 3076, Australia. Email: ;
authors.forename: Jenny
authors.initials: J
authors.lastname: Peterson
authors.affiliation: Northern Clinical Research Centre, Northern Health, 185 Cooper Street, Epping, Vic. 3076, Australia. Email:
authors.forename: Anastasia
authors.initials: A
authors.lastname: Hutchinson
authors.affiliation: Northern Clinical Research Centre, Northern Health, 185 Cooper Street, Epping, Vic. 3076, Australia. Email:
authors.forename: Terri
authors.initials: T
authors.lastname: Jackson
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems; D016208:Databases, Factual; D064420:Drug-Related Side Effects and Adverse Reactions / Q000145:classification* / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D038801:International Classification of Diseases; D010351:Patient Discharge; D014739:Victoria / Q000453:epidemiology