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Accuracy of malignant hyperthermia diagnoses in hospital discharge records
Journal article   Peer reviewed

Accuracy of malignant hyperthermia diagnoses in hospital discharge records

Teeda Pinyavat, Henry Rosenberg, Barbara H Lang, Cynthia A Wong, Sheila Riazi, Joanne E Brady, Lena S Sun and Guohua Li
Anesthesiology (Philadelphia), Vol.122(1), pp.55-63
01/2015
DOI: 10.1097/ALN.0000000000000467
PMID: 25272246

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Abstract

In 1997, the International Classification of Diseases (ICD), 9th Revision Clinical Modification (ICD-9) coding system introduced the code for malignant hyperthermia (MH) (995.86). The aim of this study was to estimate the accuracy of coding for MH in hospital discharge records. An expert panel of anesthesiologists reviewed medical records for patients with a discharge diagnosis of MH based on ICD-9 or ICD-10 codes from January 1, 2006 to December 31, 2008 at six tertiary care medical centers in North America. All cases were categorized as possible, probable, or fulminant MH, history of MH (family or personal) or other. A total of 47 medical records with MH diagnoses were reviewed; 68.1% had a documented surgical procedure and general anesthesia, and 23.4% (95% CI, 12.3-38.0%) had a possible, probable, or fulminant MH event. Dantrolene was given in 81% of the MH events. All patients judged to have an incident MH event survived to discharge. Family and personal history of MH accounted for 46.8% of cases. High fever without evidence of MH during admission accounted for 23.4%, and the reason for MH coding was unclear in 6.4% of cases. Approximately one quarter of ICD-9 or ICD-10 coded MH diagnoses in hospital discharge records refer to incident MH episodes and an additional 47% to MH susceptibility (including personal history or family history). Information such as surgical procedure, anesthesia billing data, and dantrolene administration may aid in identifying incident MH cases among those with an ICD-9 or ICD-10 coded MH diagnosis in their hospital discharge records.
 United States - epidemiology Anesthesia, General Muscle Relaxants, Central - administration & dosage Humans Middle Aged Child, Preschool Male Tertiary Care Centers - statistics & numerical data Young Adult Canada - epidemiology Medical Records - statistics & numerical data Patient Discharge - statistics & numerical data Malignant Hyperthermia - epidemiology Adult Female Dantrolene - administration & dosage Retrospective Studies Child International Classification of Diseases - statistics & numerical data Reproducibility of Results Malignant Hyperthermia - diagnosis Medical Records - standards Adolescent Aged Observer Variation

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