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Related Experiment Videos

Identification of Acute Decompensated Heart Failure Hospitalizations Using Administrative Data.

Hans Huang1, Matthew Turner1, Srihari Raju2

  • 1Department of Medicine, University of Minnesota Medical Center, Minneapolis, Minnesota.

The American Journal of Cardiology
|April 12, 2017
PubMed
Summary

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This summary is machine-generated.

Identifying hospitalizations for acute decompensated heart failure (ADHF) is crucial. A combination of ICD-9 codes, including 428.x, 402.x1, 404.x1, 415, and 518.4, improves the accuracy of ADHF event ascertainment compared to using 428.x alone.

Area of Science:

  • Cardiology
  • Health Informatics
  • Clinical Research

Background:

  • Hospitalization for acute decompensated heart failure (ADHF) is a key outcome in clinical trials and registries.
  • Accurate identification of ADHF hospitalizations using International Classification of Diseases, Ninth Revision (ICD-9) codes remains uncertain.

Purpose of the Study:

  • To identify specific ICD-9 diagnostic codes that enhance the accuracy of ascertaining ADHF hospitalizations.
  • To compare the effectiveness of different ICD-9 code combinations for ADHF identification.

Main Methods:

  • Utilized heart failure-related ICD-9 principal discharge codes from 2,202 hospitalizations (2009-2014) at the Minneapolis VA Medical Center.
  • Two independent reviewers adjudicated 447 hospitalizations to assess code accuracy.

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  • Applied findings to a nationwide sample to calculate positive predictive value (PPV), sensitivity, and accuracy.

    • Main Results:

    • Using ICD-9 code 428.x alone yielded a PPV of 91.3%, sensitivity of 97.5%, and accuracy of 89.7%.
    • Combining 428.x with codes 402.x1, 404.x1, 415, and 518.4 improved sensitivity to 99.2% and accuracy to 90.7%, while maintaining a PPV of 91.1%.
    • Excluding chronic heart failure codes (428.22, 428.32, 428.42) increased PPV to 92.3% but decreased sensitivity and accuracy.

    Conclusions:

    • A combination of ICD-9 codes (428.x, 402.x1, 404.x1, 415, 518.4) offers improved sensitivity and accuracy for identifying ADHF events compared to 428.x alone.
    • Manual adjudication of chronic heart failure codes can further refine the accuracy of this identification strategy.