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Murine Model of Controlled Cortical Impact for the Induction of Traumatic Brain Injury
Published on: August 16, 2019
Defining pediatric traumatic brain injury using International Classification of Diseases Version 10 Codes: a
Vincy Chan1,2,3, Pravheen Thurairajah4, Angela Colantonio5,6,7
1Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, ON, M5G 2A2, Canada. vincy.chan@uhn.ca.
Insights
Defining traumatic brain injury (TBI) in children using International Classification of Diseases Version 10 (ICD-10) codes lacks consistency. This review highlights the varied ICD-10 codes used, emphasizing the need for consensus in pediatric TBI research.
Area of Science:
- Public Health
- Epidemiology
- Health Services Research
Background:
- Healthcare administrative data are vital for traumatic brain injury (TBI) research.
- A lack of consensus exists on International Classification of Diseases Version 10 (ICD-10) codes for defining TBI in children and youth.
- Consistent TBI definitions are crucial for policy, resource allocation, healthcare planning, and prevention strategies.
Purpose of the Study:
- To systematically review the literature on ICD-10 codes used to define TBI in children and youth.
- To explore the range of ICD-10 codes applied in pediatric TBI research.
- To inform future efforts toward establishing a consensus definition for pediatric TBI using ICD-10 codes.
Main Methods:
- Systematic literature search across multiple databases (MEDLINE, Embase, PsychINFO, CINAHL, SPORTDiscus, Cochrane).
- Grey literature search and reference list screening.
- Independent screening of titles, abstracts, and full-text articles by two reviewers based on predefined criteria.
Main Results:
- 32 publications met eligibility criteria from 1,326 identified.
- Five articles specifically focused on TBI in children and youth (19 years and under).
- ICD-10 definitions varied widely, from broad head injury codes (S00-S09) to concussion (S06.0); code S06 (intracranial injury) showed consensus, while others were inconsistently applied.
Conclusions:
- The review provides evidence to guide discussions on appropriate ICD-10 code usage for TBI research goals.
- Establishing a consensus on ICD-10 codes is a critical first step for defining TBI in this vulnerable pediatric population.
- Informed consensus can improve the reliability and comparability of TBI research and public health initiatives.
Background:
Although healthcare administrative data are commonly used for traumatic brain injury (TBI) research, there is currently no consensus or consistency on the International Classification of Diseases Version 10 (ICD-10) codes used to define TBI among children and youth internationally. This study systematically reviewed the literature to explore the range of ICD-10 codes that are used to define TBI in this population. The identification of the range of ICD-10 codes to define this population in administrative data is crucial, as it has implications for policy, resource allocation, planning of healthcare services, and prevention strategies.
Methods:
The databases MEDLINE, MEDLINE In-Process, Embase, PsychINFO, CINAHL, SPORTDiscus, and Cochrane Database of Systematic Reviews were systematically searched. Grey literature was searched using Grey Matters and Google. Reference lists of included articles were also searched for relevant studies. Two reviewers independently screened all titles and abstracts using pre-defined inclusion and exclusion criteria. A full text screen was conducted on articles that met the first screen inclusion criteria. All full text articles that met the pre-defined inclusion criteria were included for analysis in this systematic review.
Results:
A total of 1,326 publications were identified through the predetermined search strategy and 32 articles/reports met all eligibility criteria for inclusion in this review. Five articles specifically examined children and youth aged 19 years or under with TBI. ICD-10 case definitions ranged from the broad injuries to the head codes (ICD-10 S00 to S09) to concussion only (S06.0). There was overwhelming consensus on the inclusion of ICD-10 code S06, intracranial injury, while codes S00 (superficial injury of the head), S03 (dislocation, sprain, and strain of joints and ligaments of head), and S05 (injury of eye and orbit) were only used by articles that examined head injury, none of which specifically examined children and youth.
Conclusion:
This review provides evidence for discussion on how best to use ICD codes for different goals. This is an important first step in reaching an appropriate definition and can inform future work on reaching consensus on the ICD-10 codes to define TBI for this vulnerable population.
