Diagnostic accuracy of ICD-9 code 780.2 for the identification of patients with syncope in the emergency department

  • Ludovico Furlan
  • Monica Solbiati
  • Veronica Pacetti
  • Franca Dipaola
  • Martino Meda
  • Mattia Bonzi
  • Elisa Fiorelli
  • Giulia Cernuschi
  • Daniele Alberio
  • Giovanni Casazza
  • Nicola Montano
  • Raffaello Furlan
  • Giorgio Costantino
Research Article

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.

Keywords

Syncope ICD-9 Transient loss of consciousness Sensitivity Specificity Administrative database 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they do not have conflicts of interest.

Supplementary material

10286_2018_509_MOESM1_ESM.docx (61 kb)
Supplementary material 1 (DOCX 61 kb)
10286_2018_509_MOESM2_ESM.docx (66 kb)
Supplementary material 2 (DOCX 65 kb)

References

  1. 1.
    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 30:2631–2671CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    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 51:276–283CrossRefPubMedGoogle Scholar
  3. 3.
    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–E1126CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    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):e1Google Scholar
  5. 5.
    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 49:660–664CrossRefPubMedGoogle Scholar
  6. 6.
    Goldstein LB (1998) Accuracy of ICD-9-CM coding for the identification of patients with acute ischemic stroke. Stroke 29:1602–1604CrossRefPubMedGoogle Scholar
  7. 7.
    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:e104519CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    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):e18Google Scholar
  9. 9.
    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):e5Google Scholar
  10. 10.
    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 15:595–600CrossRefPubMedGoogle Scholar
  11. 11.
    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 43:958–963CrossRefPubMedGoogle Scholar
  12. 12.
    Cernuschi G, Bonzi M, Fiorelli E, Birocchi S (2012) Do outcomes of near syncope parallel syncope? Am J Emerg Med 30:2064–2065CrossRefPubMedGoogle Scholar
  13. 13.
    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 30:203–206CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Ludovico Furlan
    • 1
    • 2
  • Monica Solbiati
    • 1
    • 2
  • Veronica Pacetti
    • 3
  • Franca Dipaola
    • 3
  • Martino Meda
    • 4
    • 5
  • Mattia Bonzi
    • 1
    • 2
  • Elisa Fiorelli
    • 1
    • 2
  • Giulia Cernuschi
    • 1
    • 2
  • Daniele Alberio
    • 6
  • Giovanni Casazza
    • 7
  • Nicola Montano
    • 1
    • 2
  • Raffaello Furlan
    • 3
  • Giorgio Costantino
    • 1
  1. 1.Dipartimento di Medicina Interna, Fondazione IRCCS Ca’ GrandaOspedale Maggiore PoliclinicoMilanItaly
  2. 2.Dipartimento di Scienze Cliniche e di ComunitàUniversità degli Studi di MilanoMilanItaly
  3. 3.Department of Biomedical SciencesHumanitas University–Humanitas Research HospitalRozzanoItaly
  4. 4.Unità Operativa di CardiologiaIstituto Scientifico Ospedale San LucaMilanItaly
  5. 5.Università degli Studi di Milano-BicoccaMilanItaly
  6. 6.Health Information ManagementHumanitas Research HospitalRozzanoItaly
  7. 7.Dipartimento di Scienze Biomediche e Cliniche “L. Sacco”Università degli Studi di MilanoMilanItaly

Personalised recommendations