title: Accuracy of malignant hyperthermia diagnoses in hospital discharge records.
abstract: BACKGROUND
  In 1997, the International Classification of Diseases (ICD), 9th Revision Clinical Modification (ICD-9) coding system introduced the code for malignant hyperthermia (MH) (995.86). The aim of this study was to estimate the accuracy of coding for MH in hospital discharge records.
  
  
  METHODS
  An expert panel of anesthesiologists reviewed medical records for patients with a discharge diagnosis of MH based on ICD-9 or ICD-10 codes from January 1, 2006 to December 31, 2008 at six tertiary care medical centers in North America. All cases were categorized as possible, probable, or fulminant MH, history of MH (family or personal) or other.
  
  
  RESULTS
  A total of 47 medical records with MH diagnoses were reviewed; 68.1% had a documented surgical procedure and general anesthesia, and 23.4% (95% CI, 12.3-38.0%) had a possible, probable, or fulminant MH event. Dantrolene was given in 81% of the MH events. All patients judged to have an incident MH event survived to discharge. Family and personal history of MH accounted for 46.8% of cases. High fever without evidence of MH during admission accounted for 23.4%, and the reason for MH coding was unclear in 6.4% of cases.
  
  
  CONCLUSIONS
  Approximately one quarter of ICD-9 or ICD-10 coded MH diagnoses in hospital discharge records refer to incident MH episodes and an additional 47% to MH susceptibility (including personal history or family history). Information such as surgical procedure, anesthesia billing data, and dantrolene administration may aid in identifying incident MH cases among those with an ICD-9 or ICD-10 coded MH diagnosis in their hospital discharge records.
authors.affiliation: From the Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, New York (T.P., B.H.L.); Department of Medical Education and Clinical Research, Saint Barnabas Medical Center, Livingston, New Jersey (H.R.); Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (C.A.W.); Department of Anesthesiology, Toronto General Hospital, Toronto, Ontario, Canada (S.R.); Departments of Anesthesiology and Epidemiology, Columbia University College of Physicians and Surgeons and Mailman School of Public Health, New York, New York (J.E.B., G.L.); and Departments of Anesthesiology and Pediatrics, Columbia University College of Physicians and Surgeons, New York, New York (L.S.S.).
authors.forename: Teeda
authors.initials: T
authors.lastname: Pinyavat
authors.forename: Henry
authors.initials: H
authors.lastname: Rosenberg
authors.forename: Barbara H
authors.initials: BH
authors.lastname: Lang
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Wong
authors.forename: Sheila
authors.initials: S
authors.lastname: Riazi
authors.forename: Joanne E
authors.initials: JE
authors.lastname: Brady
authors.forename: Lena S
authors.initials: LS
authors.lastname: Sun
authors.forename: Guohua
authors.initials: G
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003620:Dantrolene / Q000008:administration & dosage; D005260:Female; D006801:Humans; D038801:International Classification of Diseases / Q000706:statistics & numerical data*; D008297:Male; D008305:Malignant Hyperthermia / Q000175:diagnosis* / Q000453:epidemiology; D008499:Medical Records / Q000592:standards / Q000706:statistics & numerical data*; D008875:Middle Aged; D009125:Muscle Relaxants, Central / Q000008:administration & dosage; D015588:Observer Variation; D010351:Patient Discharge / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D009125:Muscle Relaxants, Central; D003620:Dantrolene