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Current ICD10 codes are insufficient to clearly distinguish acute myocardial infarction type: a descriptive study

BACKGROUND: Acute myocardial infarction (AMI) type is an important distinction to be made in both clinical and health care research context, as it determines the treatment of the patient as well as affecting outcomes. The aim of the paper was to determine the feasibility of distinguishing AMI type,...

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Autores principales: Alexandrescu, Roxana, Bottle, Alex, Jarman, Brian, Aylin, Paul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4226256/
https://www.ncbi.nlm.nih.gov/pubmed/24195773
http://dx.doi.org/10.1186/1472-6963-13-468
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author Alexandrescu, Roxana
Bottle, Alex
Jarman, Brian
Aylin, Paul
author_facet Alexandrescu, Roxana
Bottle, Alex
Jarman, Brian
Aylin, Paul
author_sort Alexandrescu, Roxana
collection PubMed
description BACKGROUND: Acute myocardial infarction (AMI) type is an important distinction to be made in both clinical and health care research context, as it determines the treatment of the patient as well as affecting outcomes. The aim of the paper was to determine the feasibility of distinguishing AMI type, either ST elevation myocardial infarction (STEMI) or non-ST elevation myocardial infarction (NSTEMI), using ICD10 codes. METHODS: We carried out a retrospective descriptive analysis of hospital administrative data on AMI emergency patients in England, for financial years 2000/1 to 2009/10. We used the performance of an angioplasty procedure on the same day and on the same or next day of hospital admission as a proxy for STEMI. RESULTS: Among the ICD10 AMI subcategories, there were inconsistent trends, with some of the codes exhibiting a gradual decline (such as I21.0 Acute transmural myocardial infarction of anterior wall, I21.1 Acute transmural myocardial infarction of inferior wall, I22.0 Subsequent myocardial infarction of anterior wall and I22.1 Subsequent myocardial infarction of inferior wall) and other codes an increase (in particular I21.9 Acute myocardial infarction, unspecified and I22.9 Subsequent myocardial infarction of unspecified site). With the exception of the codes I21.4 Acute subendocardial myocardial infarction, I21.9 Acute myocardial infarction, unspecified, I22.8 Subsequent myocardial infarction of other sites and I22.9 Subsequent myocardial infarction of unspecified site, all the other AMI subcategories appear to have undergone a significant increase in the number of angioplasty procedures performed the same or the next day of hospital admission from around 2005/6. There appear to be difficulties in accurately identifying the proportion of STEMI/NSTEMI by sole reliance on ICD10 codes. CONCLUSIONS: We suggest as the best sets of codes to select STEMI cases I21.0 to I21.3, I22.0, I22.1 and I22.8; however, without any further adaptations, ICD10 codes are insufficient to clearly distinguish acute myocardial infarction type.
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spelling pubmed-42262562014-11-11 Current ICD10 codes are insufficient to clearly distinguish acute myocardial infarction type: a descriptive study Alexandrescu, Roxana Bottle, Alex Jarman, Brian Aylin, Paul BMC Health Serv Res Research Article BACKGROUND: Acute myocardial infarction (AMI) type is an important distinction to be made in both clinical and health care research context, as it determines the treatment of the patient as well as affecting outcomes. The aim of the paper was to determine the feasibility of distinguishing AMI type, either ST elevation myocardial infarction (STEMI) or non-ST elevation myocardial infarction (NSTEMI), using ICD10 codes. METHODS: We carried out a retrospective descriptive analysis of hospital administrative data on AMI emergency patients in England, for financial years 2000/1 to 2009/10. We used the performance of an angioplasty procedure on the same day and on the same or next day of hospital admission as a proxy for STEMI. RESULTS: Among the ICD10 AMI subcategories, there were inconsistent trends, with some of the codes exhibiting a gradual decline (such as I21.0 Acute transmural myocardial infarction of anterior wall, I21.1 Acute transmural myocardial infarction of inferior wall, I22.0 Subsequent myocardial infarction of anterior wall and I22.1 Subsequent myocardial infarction of inferior wall) and other codes an increase (in particular I21.9 Acute myocardial infarction, unspecified and I22.9 Subsequent myocardial infarction of unspecified site). With the exception of the codes I21.4 Acute subendocardial myocardial infarction, I21.9 Acute myocardial infarction, unspecified, I22.8 Subsequent myocardial infarction of other sites and I22.9 Subsequent myocardial infarction of unspecified site, all the other AMI subcategories appear to have undergone a significant increase in the number of angioplasty procedures performed the same or the next day of hospital admission from around 2005/6. There appear to be difficulties in accurately identifying the proportion of STEMI/NSTEMI by sole reliance on ICD10 codes. CONCLUSIONS: We suggest as the best sets of codes to select STEMI cases I21.0 to I21.3, I22.0, I22.1 and I22.8; however, without any further adaptations, ICD10 codes are insufficient to clearly distinguish acute myocardial infarction type. BioMed Central 2013-11-07 /pmc/articles/PMC4226256/ /pubmed/24195773 http://dx.doi.org/10.1186/1472-6963-13-468 Text en Copyright © 2013 Alexandrescu et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Alexandrescu, Roxana
Bottle, Alex
Jarman, Brian
Aylin, Paul
Current ICD10 codes are insufficient to clearly distinguish acute myocardial infarction type: a descriptive study
title Current ICD10 codes are insufficient to clearly distinguish acute myocardial infarction type: a descriptive study
title_full Current ICD10 codes are insufficient to clearly distinguish acute myocardial infarction type: a descriptive study
title_fullStr Current ICD10 codes are insufficient to clearly distinguish acute myocardial infarction type: a descriptive study
title_full_unstemmed Current ICD10 codes are insufficient to clearly distinguish acute myocardial infarction type: a descriptive study
title_short Current ICD10 codes are insufficient to clearly distinguish acute myocardial infarction type: a descriptive study
title_sort current icd10 codes are insufficient to clearly distinguish acute myocardial infarction type: a descriptive study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4226256/
https://www.ncbi.nlm.nih.gov/pubmed/24195773
http://dx.doi.org/10.1186/1472-6963-13-468
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