Accuracy and yield of ICD-9 codes for identifying children with ischemic stroke

Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, United States
Neurology (Impact Factor: 8.29). 05/2007; 67(11):2053-5. DOI: 10.1212/01.wnl.0000247281.98094.e2
Source: PubMed


The medical records of all children at our hospital with International Classification of Diseases 9th revision (ICD-9) codes 342, 433 to 438, or 767 from May 1999 to May 2004 were reviewed to assess whether they had stroke (any type) or, specifically, arterial ischemic stroke (AIS). Code accuracy ranged from 37 to 88%; each code missed more than half of AIS identified by the combined code search. Studies are needed to determine whether other local and national ICD-9 databases have similar limitations.

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    • "Before the advent of MRI techniques , a Mayo Clinic retrospective analysis of cases in Rochester, Minnesota , in the late 1970s yielded an incidence of 2.5 strokes per 100,000 children per year [6]. Although pre-MRI data likely underestimate the incidence of AIS because of the low sensitivity of CT for ischemia, more recent retrospective analyses using medical record review are subject to well-documented inaccuracies engendered by the International Statistical Classification of Diseases, 9th Revision coding [7]. In addition, given the low index of suspicion for cerebrovascular events in children, the true incidence of pediatric AIS likely remains underdiagnosed. "
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