Multisite medical record review of emergency department visits for traumatic brain injury.

Autor:	Gabella BA; Violence and Injury Prevention - Mental Health Promotion Branch, Colorado Department of Public Health and Environment, Denver, Colorado, USA Barbara.gabella@state.co.us., Hathaway JE; Office of Statistics and Evaluation, Massachusetts Department of Public Health, Boston, Massachusetts, USA., Hume B; Office of Statistics and Evaluation, Massachusetts Department of Public Health, Boston, Massachusetts, USA., Johnson J; Violence and Injury Prevention - Mental Health Promotion Branch, Colorado Department of Public Health and Environment, Denver, Colorado, USA., Costich JF; Department of Health Management and Policy, University of Kentucky, Lexington, Kentucky, USA., Slavova S; Kentucky Injury Prevention and Research Center, University of KY, Lexington, Kentucky, USA., Liu AY; Center for Environmental and Occupational Epidemiology, Maryland Department of Health, Baltimore, Maryland, USA.
Jazyk:	angličtina
Zdroj:	Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention [Inj Prev] 2021 Mar; Vol. 27 (S1), pp. i42-i48.
DOI:	10.1136/injuryprev-2019-043510
Abstrakt:	Background: In 2016, the CDC in the USA proposed codes from the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) for identifying traumatic brain injury (TBI). This study estimated positive predictive value (PPV) of TBI for some of these codes. Methods: Four study sites used emergency department or trauma records from 2015 to 2018 to identify two random samples within each site selected by ICD-10-CM TBI codes for (1) intracranial injury (S06) or (2) skull fracture only (S02.0, S02.1-, S02.8-, S02.91) with no other TBI codes. Using common protocols, reviewers abstracted TBI signs and symptoms and head imaging results that were then used to assign certainty of TBI (none, low, medium, high) to each sampled record. PPVs were estimated as a percentage of records with medium-certainty or high-certainty for TBI and reported with 95% confidence interval (CI). Results: PPVs for intracranial injury codes ranged from 82% to 92% across the four samples. PPVs for skull fracture codes were 57% and 61% in the two university/trauma hospitals in each of two states with clinical reviewers, and 82% and 85% in the two states with professional coders reviewing statewide or nearly statewide samples. Margins of error for the 95% CI for all PPVs were under 5%. Discussion: ICD-10-CM codes for traumatic intracranial injury demonstrated high PPVs for capturing true TBI in different healthcare settings. The algorithm for TBI certainty may need refinement, because it yielded moderate-to-high PPVs for records with skull fracture codes that lacked intracranial injury codes. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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