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BMC Neurology

, 17:121

Cerebrovascular disease and stroke

Abstract

BackgroundAlthough International Classification of Disease, Ninth Revision, Clinical Modification ICD9-CM coding is the basis of administrative claims data, no study has validated an ICD9-CM algorithm to identify patients undergoing decompressive craniectomy for space-occupying supratentorial infarction.

MethodsPatients who underwent decompressive craniectomy for stroke at our institution were retrospectively identified and their associated ICD9-CM codes were extracted from billing data. An ICD9-CM algorithm was generated and its accuracy compared against physician review.

ResultsA total of 10,925 neurosurgical operations were performed from December 2008 to March 2015, of which 46 0.4% were decompressive craniectomy for space-occupying stroke. The ICD9-CM procedure code for craniectomy 01.25 was only encoded in 67.4% of patients, while craniotomy 01.24 was used in 19.6% and lobectomy 01.39, 01.53, 01.59 in 13.1%. The ICD-9-CM algorithm included patients with a diagnosis codes for cerebral infarction 433.11, 434.01, 434.11, and 434.91 and a procedure code for craniotomy, craniectomy, or lobectomy. Patients were excluded with an ICD9-CM diagnosis code for brain tumor, intracranial abscess, subarachnoid hemorrhage, vertebrobasilar infarction, intracranial aneurysm, Moyamoya disease, intracranial venous sinus thrombosis, vertebral artery dissection, congenital cerebrovascular anomaly, head trauma or an ICD9-CM procedure code for laminectomy. This algorithm had a sensitivity of 97.8%, specificity of 99.9%, positive predictive value of 88.2%, and negative predictive value of 99.9%. The majority of false-positive results were patients who underwent evacuation of a primary intracerebral hematoma.

ConclusionAn ICD-9-CM algorithm based on diagnosis and procedure codes can effectively identify patients undergoing decompressive craniectomy for supratentorial stroke.

KeywordsDecompressive craniectomy International classification of disease Ischemic stroke Validation AbbreviationsICHIntracerebral hemorrhage

MCAMiddle cerebral artery

TPATissue plasminogen activator

ICD9-CMInternational Classification of Diseases, Ninth Edition, Clinical Modification

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Autor: Hormuzdiyar H. Dasenbrock - David J. Cote - Yuri Pompeu - Viren S. Vasudeva - Timothy R. Smith - William B. Gormley

Fuente: https://link.springer.com/



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