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Missed Registration of Disease Codes for Pediatric Anaphylaxis at the Emergency Department

BACKGROUND: It is important to register anaphylaxis codes correctly to study the exact prevalence of anaphylaxis. The purpose of this study was to analyze the clinical characteristics and disease codes of inaccurately registered groups in pediatric anaphylaxis patients. METHODS: This study reviewed...

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Autores principales: Choi, Byungho, Kim, Sun Hyu, Lee, Hyeji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6710778/
https://www.ncbi.nlm.nih.gov/pubmed/31485351
http://dx.doi.org/10.1155/2019/4198630
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author Choi, Byungho
Kim, Sun Hyu
Lee, Hyeji
author_facet Choi, Byungho
Kim, Sun Hyu
Lee, Hyeji
author_sort Choi, Byungho
collection PubMed
description BACKGROUND: It is important to register anaphylaxis codes correctly to study the exact prevalence of anaphylaxis. The purpose of this study was to analyze the clinical characteristics and disease codes of inaccurately registered groups in pediatric anaphylaxis patients. METHODS: This study reviewed the medical records of all pediatric patients who presented to the university hospital emergency department over a 5-year period. Study subjects were divided into 2 groups: the accurate group, including those registered under anaphylaxis codes, and the inaccurate coding group, including those registered under other codes. RESULTS: From a total of 79,676 pediatric patients, 184 (0.23%) had anaphylaxis. Of these, 23 (12.5%) and 161 (87.5%) patients were classified to the accurate and inaccurate coding groups, respectively. Average age, time from symptom onset to emergency department presentation, past history of allergy, and penicillin and cephalosporin as causes of anaphylaxis differed between the 2 groups. Cardiovascular (39.1% vs. 5.6%, p=0.001) and respiratory symptoms (65.2% vs. 42.2%, p=0.038) manifested more frequently in the accurate group, while gastrointestinal symptoms (68.3% vs. 26.1%, p=0.001) were more frequently observed in the inaccurate coding group. Fluid administration (82.6% vs. 28.0%, p=0.001), steroid use (60.9% vs. 23.0%, p=0.001), and epinephrine use (65.2% vs. 13.0% p=0.001) were more common treatments for anaphylaxis in the emergency department in the accurate group. Anaphylaxis patients with cardiovascular symptoms, steroid use, and epinephrine use were more likely to be accurately registered with anaphylaxis disease codes. CONCLUSIONS: In the case of pediatric anaphylaxis, more patients were registered inaccurately under other allergy-related codes and simple symptom codes, rather than under anaphylaxis codes. Therefore, future research on anaphylaxis should consider inaccurately registered anaphylactic patients, as shown in this study.
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spelling pubmed-67107782019-09-04 Missed Registration of Disease Codes for Pediatric Anaphylaxis at the Emergency Department Choi, Byungho Kim, Sun Hyu Lee, Hyeji Emerg Med Int Research Article BACKGROUND: It is important to register anaphylaxis codes correctly to study the exact prevalence of anaphylaxis. The purpose of this study was to analyze the clinical characteristics and disease codes of inaccurately registered groups in pediatric anaphylaxis patients. METHODS: This study reviewed the medical records of all pediatric patients who presented to the university hospital emergency department over a 5-year period. Study subjects were divided into 2 groups: the accurate group, including those registered under anaphylaxis codes, and the inaccurate coding group, including those registered under other codes. RESULTS: From a total of 79,676 pediatric patients, 184 (0.23%) had anaphylaxis. Of these, 23 (12.5%) and 161 (87.5%) patients were classified to the accurate and inaccurate coding groups, respectively. Average age, time from symptom onset to emergency department presentation, past history of allergy, and penicillin and cephalosporin as causes of anaphylaxis differed between the 2 groups. Cardiovascular (39.1% vs. 5.6%, p=0.001) and respiratory symptoms (65.2% vs. 42.2%, p=0.038) manifested more frequently in the accurate group, while gastrointestinal symptoms (68.3% vs. 26.1%, p=0.001) were more frequently observed in the inaccurate coding group. Fluid administration (82.6% vs. 28.0%, p=0.001), steroid use (60.9% vs. 23.0%, p=0.001), and epinephrine use (65.2% vs. 13.0% p=0.001) were more common treatments for anaphylaxis in the emergency department in the accurate group. Anaphylaxis patients with cardiovascular symptoms, steroid use, and epinephrine use were more likely to be accurately registered with anaphylaxis disease codes. CONCLUSIONS: In the case of pediatric anaphylaxis, more patients were registered inaccurately under other allergy-related codes and simple symptom codes, rather than under anaphylaxis codes. Therefore, future research on anaphylaxis should consider inaccurately registered anaphylactic patients, as shown in this study. Hindawi 2019-08-14 /pmc/articles/PMC6710778/ /pubmed/31485351 http://dx.doi.org/10.1155/2019/4198630 Text en Copyright © 2019 Byungho Choi et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Choi, Byungho
Kim, Sun Hyu
Lee, Hyeji
Missed Registration of Disease Codes for Pediatric Anaphylaxis at the Emergency Department
title Missed Registration of Disease Codes for Pediatric Anaphylaxis at the Emergency Department
title_full Missed Registration of Disease Codes for Pediatric Anaphylaxis at the Emergency Department
title_fullStr Missed Registration of Disease Codes for Pediatric Anaphylaxis at the Emergency Department
title_full_unstemmed Missed Registration of Disease Codes for Pediatric Anaphylaxis at the Emergency Department
title_short Missed Registration of Disease Codes for Pediatric Anaphylaxis at the Emergency Department
title_sort missed registration of disease codes for pediatric anaphylaxis at the emergency department
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6710778/
https://www.ncbi.nlm.nih.gov/pubmed/31485351
http://dx.doi.org/10.1155/2019/4198630
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