Abstract
Purpose
Syncope is a common condition that affects individuals of all ages and is responsible for 1–3% of all emergency department (ED) visits. Prospective studies on syncope are often limited by the exiguous number of subjects enrolled. A possible alternative approach would be to use of hospital discharge diagnoses from administrative databases to identify syncope subjects in epidemiological observational studies. We assessed the accuracy of the International Classification of Diseases, Ninth Revision (ICD-9) code 780.2 “syncope and collapse” to identify patients with syncope.
Methods
Patients in two teaching hospitals in Milan, Italy with a triage assessment for ED access that was possibly related to syncope were recruited in this study. We considered the index test to be the attribution of the ICD-9 code 780.2 at ED discharge and the reference standard to be the diagnosis of syncope by the ED physician.
Results
The sensitivity, specificity, positive and negative predictive values of the ICD-9 code 780.2 to identify patients with syncope were 0.63 (95% confidence interval [CI] 0.58–0.67), 0.98 (95% CI 0.98–0.99), 0.83 (95% CI 0.79–0.87) and 0.95 (95% CI 0.94–0.95), respectively.
Conclusions
The moderate sensitivity of ICD-9 code 780.2 should be considered when the code is used to identify patients with syncope through administrative databases.
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References
Moya A, Sutton R, Ammirati F, Blanc JJ, Brignole M, Dahm JB et al (2009) Guidelines for the diagnosis and management of syncope (version 2009). Eur Heart J 30:2631–2671
Costantino G, Perego F, Dipaola F, Borella M, Galli A, Cantoni G et al (2008) Short- and long-term prognosis of syncope, risk factors, and role of hospital admission. results from the STePS (short-term prognosis of syncope) study. J Am Coll Cardiol 51:276–283
Saccilotto RT, Nickel CH, Bucher HC, Steyerberg EW, Bingisser R, Koller MT (2011) San Francisco syncope rule to predict short-term serious outcomes: a systematic review. CMAJ 183:E1116–E1126
Serrano LA, Hess EP, Bellolio MF, Murad MH, Montori VM, Erwin PJ et al (2010) Accuracy and quality of clinical decision rules for syncope in the emergency department: a systematic review and meta-analysis. Ann Emerg Med 56(362–373):e1
Benesch C, Witter DM, Wilder AL, Duncan PW, Samsa GP, Matchar DB (1997) Inaccuracy of the International Classification of Diseases (ICD-9-CM) in identifying the diagnosis of ischemic cerebrovascular disease. Neurology 49:660–664
Goldstein LB (1998) Accuracy of ICD-9-CM coding for the identification of patients with acute ischemic stroke. Stroke 29:1602–1604
McCormick N, Lacaille D, Bhole V, Avina-Zubieta JA (2014) Validity of heart failure diagnoses in administrative databases: a systematic review and meta-analysis. PLoS One 9:e104519
Wendelboe AM, Campbell J, McCumber M, Bratzler D, Ding K, Beckman M et al (2015) The design and implementation of a new surveillance system for venous thromboembolism using combined active and passive methods. Am Heart J 170(447–454):e18
Sun BC, Derose SF, Liang LJ, Gabayan GZ, Hoffman JR, Moore AA et al (2009) Predictors of 30-day serious events in older patients with syncope. Ann Emerg Med 54(769–778):e5
Ruwald MH, Hansen ML, Lamberts M, Kristensen SL, Wissenberg M, Olsen A-MS et al (2013) Accuracy of the ICD-10 discharge diagnosis for syncope. Europace 15:595–600
Grossman SA, Babineau M, Burke L, Kancharla A, Mottley L, Nencioni A et al (2012) Applying the Boston syncope criteria to near syncope. J Emerg Med 43:958–963
Cernuschi G, Bonzi M, Fiorelli E, Birocchi S (2012) Do outcomes of near syncope parallel syncope? Am J Emerg Med 30:2064–2065
Grossman SA, Babineau M, Burke L, Kancharla A, Mottley L, Nencioni A et al (2012) Do outcomes of near syncope parallel syncope? Am J Emerg Med 30:203–206
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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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Furlan, L., Solbiati, M., Pacetti, V. et al. Diagnostic accuracy of ICD-9 code 780.2 for the identification of patients with syncope in the emergency department. Clin Auton Res 28, 577–582 (2018). https://doi.org/10.1007/s10286-018-0509-z
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DOI: https://doi.org/10.1007/s10286-018-0509-z