Exploring in-hospital adverse drug events using ICD-10 codes

• Published in: Australian health review 2014-01, Vol.38 (4), p.454-460
• Main Authors: Parikh, Sumit, Christensen, Donna, Stuchbery, Peter, Peterson, Jenny, Hutchinson, Anastasia, Jackson, Terri
• Format: Article
• Language: English
• Subjects: Adverse Drug Reaction Reporting Systems; Algorithms; Classification; Clinical outcomes; Codes; Coding standards; Databases, Factual; Diagnosis related groups; DRGs; Drug therapy; Drug-Related Side Effects and Adverse Reactions - classification; Drug-Related Side Effects and Adverse Reactions - epidemiology; Health administration; Health care; Hospitalization; Hospitals; Humans; International Classification of Diseases; Medical diagnosis; Medical personnel; Patient admissions; Patient Discharge; Quality improvement; Software; Studies; Suburban areas; Toxicity; Victoria - epidemiology
• ISSN: 0156-5788; 1449-8944
• DOI: 10.1071/AH13166

Adverse drug events (ADEs) during hospital admissions are a widespread problem associated with adverse patient outcomes. The 'external cause' codes in the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) provide opportunities for identifying the incidence of ADEs acquired during hospital stays that may assist in targeting interventions to decrease their occurrence. The aim of the present study was to use routine administrative data to identify ADEs acquired during hospital admissions in a suburban healthcare network in Melbourne, Australia. Thirty-nine secondary diagnosis fields of hospital discharge data for a 1-year period were reviewed for 'diagnoses not present on admission' and assigned to the Classification of Hospital Acquired Diagnoses (CHADx) subclasses. Discharges with one or more ADE subclass were extracted for retrospective analysis. From 57205 hospital discharges, 7891 discharges (13.8%) had at least one CHADx, and 402 discharges (0.7%) had an ADE recorded. The highest proportion of ADEs was due to administration of analgesics (27%) and systemic antibiotics (23%). Other major contributors were anticoagulation (13%), anaesthesia (9%) and medications with cardiovascular side-effects (9%). Hospital data coded in ICD-10 can be used to identify ADEs that occur during hospital stays and also clinical conditions, therapeutic drug classes and treating units where these occur. Using the CHADx algorithm on administrative datasets provides a consistent and economical method for such ADE monitoring.