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197. Infective Endocarditis Over a Five-Year Period in an Academic Teaching Center: The Validity of ICD Codes vs. Manual Chart Review

BACKGROUND: Opioid dependence and overdose are at epidemic levels in the United States. Ohio has the third highest rate of opioid-related overdose deaths. Infectious complications of intravenous drug use (IDU) include increased acquisition of hepatitis C, HIV and infective endocarditis. In this stud...

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Autores principales: Haden, Michael, Mahdee Sobhanie, Mohammad, Hebert, Courtney, Castillejo Becerra, Clara, Turner, Abigail N
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6810795/
http://dx.doi.org/10.1093/ofid/ofz360.272
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author Haden, Michael
Mahdee Sobhanie, Mohammad
Hebert, Courtney
Castillejo Becerra, Clara
Turner, Abigail N
author_facet Haden, Michael
Mahdee Sobhanie, Mohammad
Hebert, Courtney
Castillejo Becerra, Clara
Turner, Abigail N
author_sort Haden, Michael
collection PubMed
description BACKGROUND: Opioid dependence and overdose are at epidemic levels in the United States. Ohio has the third highest rate of opioid-related overdose deaths. Infectious complications of intravenous drug use (IDU) include increased acquisition of hepatitis C, HIV and infective endocarditis. In this study, we aimed to characterize cases of infective endocarditis admitted to our healthcare system over a five-year period. We additionally sought to determine the validity of using ICD codes to identify infective endocarditis cases and IDU. METHODS: Patients with ICD-9 or 10 discharge diagnosis codes for infective endocarditis were identified from our institution’s electronic health record. ICD codes pertaining to substance abuse were used to classify patients according to IDU status. Readmissions during the same episode of infective endocarditis were excluded. We compared chart review to ICD code for the identification of infective endocarditis and IDU in a random sample of 296 of 1590 cases. RESULTS: Of 296 charts reviewed, 133 (44.9%) were excluded because they did not meet criteria for definite infective endocarditis by modified Duke’s criteria or because the episode was a readmission. A total of 163 (55.1%) cases met inclusion criteria, all of whom were seen in consultation by the inpatient Infectious Disease service. Of these, 52 (31.9%) had ICD 9 or 10 codes linked to substance abuse. Following manual chart review, we established that in fact 86 of these 163 cases (52.8%) had evidence of substance abuse. CONCLUSION: Misclassification due to use of ICD codes is a well-established challenge to epidemiological research. However, the extent of misclassification in this analysis was greater than expected. If prior research on IDU and infective endocarditis has relied on medical record data alone without verification through manual chart review, the observed epidemiological trends may not be accurate. DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-68107952019-10-28 197. Infective Endocarditis Over a Five-Year Period in an Academic Teaching Center: The Validity of ICD Codes vs. Manual Chart Review Haden, Michael Mahdee Sobhanie, Mohammad Hebert, Courtney Castillejo Becerra, Clara Turner, Abigail N Open Forum Infect Dis Abstracts BACKGROUND: Opioid dependence and overdose are at epidemic levels in the United States. Ohio has the third highest rate of opioid-related overdose deaths. Infectious complications of intravenous drug use (IDU) include increased acquisition of hepatitis C, HIV and infective endocarditis. In this study, we aimed to characterize cases of infective endocarditis admitted to our healthcare system over a five-year period. We additionally sought to determine the validity of using ICD codes to identify infective endocarditis cases and IDU. METHODS: Patients with ICD-9 or 10 discharge diagnosis codes for infective endocarditis were identified from our institution’s electronic health record. ICD codes pertaining to substance abuse were used to classify patients according to IDU status. Readmissions during the same episode of infective endocarditis were excluded. We compared chart review to ICD code for the identification of infective endocarditis and IDU in a random sample of 296 of 1590 cases. RESULTS: Of 296 charts reviewed, 133 (44.9%) were excluded because they did not meet criteria for definite infective endocarditis by modified Duke’s criteria or because the episode was a readmission. A total of 163 (55.1%) cases met inclusion criteria, all of whom were seen in consultation by the inpatient Infectious Disease service. Of these, 52 (31.9%) had ICD 9 or 10 codes linked to substance abuse. Following manual chart review, we established that in fact 86 of these 163 cases (52.8%) had evidence of substance abuse. CONCLUSION: Misclassification due to use of ICD codes is a well-established challenge to epidemiological research. However, the extent of misclassification in this analysis was greater than expected. If prior research on IDU and infective endocarditis has relied on medical record data alone without verification through manual chart review, the observed epidemiological trends may not be accurate. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6810795/ http://dx.doi.org/10.1093/ofid/ofz360.272 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Haden, Michael
Mahdee Sobhanie, Mohammad
Hebert, Courtney
Castillejo Becerra, Clara
Turner, Abigail N
197. Infective Endocarditis Over a Five-Year Period in an Academic Teaching Center: The Validity of ICD Codes vs. Manual Chart Review
title 197. Infective Endocarditis Over a Five-Year Period in an Academic Teaching Center: The Validity of ICD Codes vs. Manual Chart Review
title_full 197. Infective Endocarditis Over a Five-Year Period in an Academic Teaching Center: The Validity of ICD Codes vs. Manual Chart Review
title_fullStr 197. Infective Endocarditis Over a Five-Year Period in an Academic Teaching Center: The Validity of ICD Codes vs. Manual Chart Review
title_full_unstemmed 197. Infective Endocarditis Over a Five-Year Period in an Academic Teaching Center: The Validity of ICD Codes vs. Manual Chart Review
title_short 197. Infective Endocarditis Over a Five-Year Period in an Academic Teaching Center: The Validity of ICD Codes vs. Manual Chart Review
title_sort 197. infective endocarditis over a five-year period in an academic teaching center: the validity of icd codes vs. manual chart review
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6810795/
http://dx.doi.org/10.1093/ofid/ofz360.272
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