Skip to main content
    • Aa
    • Aa
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 25
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Dharmarajan, Kumar Strait, Kelly M. Tinetti, Mary E. Lagu, Tara Lindenauer, Peter K. Lynn, Joanne Krukas, Michelle R. Ernst, Frank R. Li, Shu-Xia and Krumholz, Harlan M. 2016. Treatment for Multiple Acute Cardiopulmonary Conditions in Older Adults Hospitalized with Pneumonia, Chronic Obstructive Pulmonary Disease, or Heart Failure. Journal of the American Geriatrics Society, Vol. 64, Issue. 8, p. 1574.

    Filion, Kristian B. Eberg, Maria and Ernst, Pierre 2016. Confounding by drug formulary restriction in pharmacoepidemiologic research. Pharmacoepidemiology and Drug Safety, Vol. 25, Issue. 3, p. 278.

    Momosaki, Ryo Yasunaga, Hideo Matsui, Hiroki Fushimi, Kiyohide and Abo, Masahiro 2016. Proton Pump Inhibitors versus Histamine-2 Receptor Antagonists and Risk of Pneumonia in Patients with Acute Stroke. Journal of Stroke and Cerebrovascular Diseases, Vol. 25, Issue. 5, p. 1035.

    Momosaki, Ryo Yasunaga, Hideo Matsui, Hiroki Horiguchi, Hiromasa Fushimi, Kiyohide and Abo, Masahiro 2016. Predictive factors for oral intake after aspiration pneumonia in older adults. Geriatrics & Gerontology International, Vol. 16, Issue. 5, p. 556.

    Quan, T Phuong Fawcett, Nicola J Wrightson, John M Finney, John Wyllie, David Jeffery, Katie Jones, Nicola Shine, Brian Clarke, Lorraine Crook, Derrick Walker, A Sarah and Peto, Timothy E A 2016. Increasing burden of community-acquired pneumonia leading to hospitalisation, 1998–2014. Thorax, Vol. 71, Issue. 6, p. 535.

    Bottle, Alex Goudie, Rosalind Cowie, Martin R Bell, Derek and Aylin, Paul 2015. Relation between process measures and diagnosis-specific readmission rates in patients with heart failure. Heart, Vol. 101, Issue. 21, p. 1704.

    Faillie, J.-L. Filion, K. B. Patenaude, V. Ernst, P. and Azoulay, L. 2015. Dipeptidyl peptidase-4 inhibitors and the risk of community-acquired pneumonia in patients with type 2 diabetes. Diabetes, Obesity and Metabolism, Vol. 17, Issue. 4, p. 379.

    Momosaki, Ryo Yasunaga, Hideo Matsui, Hiroki Horiguchi, Hiromasa Fushimi, Kiyohide and Abo, Masahiro 2015. Effect of dysphagia rehabilitation on oral intake in elderly patients with aspiration pneumonia. Geriatrics & Gerontology International, Vol. 15, Issue. 6, p. 694.

    Momosaki, Ryo Yasunaga, Hideo Matsui, Hiroki Horiguchi, Hiromasa Fushimi, Kiyohide and Abo, Masahiro 2015. Effect of Early Rehabilitation by Physical Therapists on In-hospital Mortality After Aspiration Pneumonia in the Elderly. Archives of Physical Medicine and Rehabilitation, Vol. 96, Issue. 2, p. 205.

    Dang, T. T. Eurich, D. T. Weir, D. L. Marrie, T. J. and Majumdar, S. R. 2014. Rates and Risk Factors for Recurrent Pneumonia in Patients Hospitalized With Community-Acquired Pneumonia: Population-Based Prospective Cohort Study With 5 Years of Follow-up. Clinical Infectious Diseases, Vol. 59, Issue. 1, p. 74.

    Filion, Kristian B Chateau, Dan Targownik, Laura E Gershon, Andrea Durand, Madeleine Tamim, Hala Teare, Gary F Ravani, Pietro Ernst, Pierre and Dormuth, Colin R 2014. Proton pump inhibitors and the risk of hospitalisation for community-acquired pneumonia: replicated cohort studies with meta-analysis. Gut, Vol. 63, Issue. 4, p. 552.

    Murdoch, Katherine M. Mitra, Biswadev Lambert, Stephen and Erbas, Bircan 2014. What is the seasonal distribution of community acquired pneumonia over time? A systematic review. Australasian Emergency Nursing Journal, Vol. 17, Issue. 1, p. 30.

    Prescott, Hallie C. Sjoding, Michael W. and Iwashyna, Theodore J. 2014. Diagnoses of Early and Late Readmissions after Hospitalization for Pneumonia. A Systematic Review. Annals of the American Thoracic Society, Vol. 11, Issue. 7, p. 1091.

    Buzzo, Alfonso Rosado Roberts, Craig Mollinedo, Lourdes García Quevedo, Joaquin Mould Casas, Gerardo Luna and Soldevilla, José Manuel Sobrino 2013. Morbidity and mortality of pneumonia in adults in six Latin American countries. International Journal of Infectious Diseases, Vol. 17, Issue. 9, p. e673.

    Drahos, Jennifer Vanwormer, Jeffrey J. Greenlee, Robert T. Landgren, Ola and Koshiol, Jill 2013. Accuracy of ICD-9-CM codes in identifying infections of pneumonia and herpes simplex virus in administrative data. Annals of Epidemiology, Vol. 23, Issue. 5, p. 291.

    Eurich, D. T. Lee, C. Marrie, T. J. and Majumdar, S. R. 2013. Inhaled Corticosteroids and Risk of Recurrent Pneumonia: A Population-Based, Nested Case-Control Study. Clinical Infectious Diseases, Vol. 57, Issue. 8, p. 1138.

    Berezin, Eitan Namaan Moraes, José Cássio de Hong, Ting Todd, Mark and Seljan, Maria Palma 2012. Pneumonia hospitalization in Brazil from 2003 to 2007. International Journal of Infectious Diseases, Vol. 16, Issue. 8, p. e583.

    Davis, Kailah Staes, Catherine Duncan, Jeff Igo, Sean and Facelli, Julio C 2012. Identification of pneumonia and influenza deaths using the death certificate pipeline. BMC Medical Informatics and Decision Making, Vol. 12, Issue. 1,

    James, Matthew T. and Laupland, Kevin B. 2012. Examining Noncardiovascular Morbidity in CKD: Estimated GFR and the Risk of Infection. American Journal of Kidney Diseases, Vol. 59, Issue. 3, p. 327.

    Eurich, D. T. Gamble, J. M. Marrie, T. J. and Majumdar, S. R. 2010. Dysglycaemia and 90 day and 1 year risks of death or readmission in patients hospitalised for community-acquired pneumonia. Diabetologia, Vol. 53, Issue. 3, p. 497.


ICD-10 codes are a valid tool for identification of pneumonia in hospitalized patients aged ⩾65 years

  • S. A. SKULL (a1) (a2), R. M. ANDREWS (a2), G. B. BYRNES (a3), D. A. CAMPBELL (a3) (a4), T. M. NOLAN (a3), G. V. BROWN (a5) and H. A. KELLY (a3) (a6)
  • DOI:
  • Published online: 20 April 2007

This study examines the validity of using ICD-10 codes to identify hospitalized pneumonia cases. Using a case-cohort design, subjects were randomly selected from monthly cohorts of patients aged ⩾65 years discharged from April 2000 to March 2002 from two large tertiary Australian hospitals. Cases had ICD-10-AM codes J10–J18 (pneumonia); the cohort sample was randomly selected from all discharges, frequency matched to cases by month. Codes were validated against three comparators: medical record notation of pneumonia, chest radiograph (CXR) report and both. Notation of pneumonia was determined for 5098/5101 eligible patients, and CXR reports reviewed for 3349/3464 (97%) patients with a CXR. Coding performed best against notation of pneumonia: kappa 0·95, sensitivity 97·8% (95% CI 97·1–98·3), specificity 96·9% (95% CI 96·2–97·5), positive predictive value (PPV) 96·2% (95% CI 95·4–97·0) and negative predictive value (NPV) 98·2% (95% CI 97·6–98·6). When medical record notation of pneumonia is used as the standard, ICD-10 codes are a valid method for retrospective ascertainment of hospitalized pneumonia cases and appear superior to use of complexes of symptoms and signs, or radiology reports.

Corresponding author
*Author for correspondence: Dr S. A. Skull, Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Flemington Rd, Parkville, Victoria, Australia3052. (Email:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

PR Smith . What diagnostic tests are needed for community-acquired pneumonia? Medical Clinics of North America 2001; 85: 13811396.

MJ Fine , T Chowdhry , A Ketema . Outpatient management of community-acquired pneumonia. Hospital Practice (Office Edition) 1998; 33: 123133.

JP Metlay , Influence of age on symptoms at presentation in patients with community-acquired pneumonia. Archives of Internal Medicine 1997; 157: 14531459.

TJ Marrie , Community-acquired pneumonia requiring hospitalization. Is it different in the elderly? Journal of the American Geriatrics Society 1985; 33: 671680.

MN Albaum , Interobserver reliability of the chest radiograph in community-acquired pneumonia. PORT Investigators. Chest 1996; 110: 343350.

H Syrjala , High-resolution computed tomography for the diagnosis of community-acquired pneumonia. Clinical Infectious Diseases 1998; 27: 358363.

KL Nichol , The health and economic benefits associated with pneumococcal vaccination of elderly persons with chronic lung disease. Archives of Internal Medicine 1999; 159: 24372442.

B Christenson , Effects of a large-scale intervention with influenza and 23-valent pneumococcal vaccines in adults aged 65 years or older: a prospective study. Lancet 2001; 357: 10081011.

K Dear , Vaccines for preventing pneumococcal infection in adults [Cochrane Review]. The Cochrane Database of Systematic Reviews ( Accessed 24 February 2004.

A Vila-Córcoles , Protective effect of pneumococcal vaccine against death by pneumonia in elderly subjects. European Respiratory Journal 2005; 26: 10861091.

DN Fisman , Prior pneumococcal vaccination is associated with reduced death, complications, and length of stay among hospitalized adults with community-acquired pneumonia. Clinical Infectious Diseases 2006; 42: 10931101.

TJ Marrie , H Durant , E Sealy . Pneumonia – the quality of medical records data. Medical Care 1987; 25: 2024.

J Whittle , Community-acquired pneumonia: can it be defined with claims data? American Journal of Medical Quality 1997; 12: 187193.

RE Guevara , Accuracy of ICD-9-CM codes in detecting community-acquired pneumococcal pneumonia for incidence and vaccine efficacy studies. American Journal of Epidemiology 1999; 149: 282289.

GW Comstock . Evaluating vaccination effectiveness and vaccine efficacy by means of case-control studies. Epidemiologic Reviews 1994; 16: 7789.

S Wacholder . Practical considerations in choosing between the case-cohort and nested case-control designs. Epidemiology 1991; 2: 155158.

National Centre for Classification in Health. International Statistical Classification of Diseases and Related Health Problems, 10th Edition, Australian Modification, 1st edn. Sydney: University of Sydney, 1998.

The National Centre for Classification in Health. ICD-10-AM Australian Coding Standards, 2nd edn. Sydney: The National Centre for Classification in Health, 2000.

JM Last . A Dictionary of Epidemiology, 3rd edn. New York: Oxford University Press, 1995.

AM Neill , Community acquired pneumonia: aetiology and usefulness of severity criteria on admission. Thorax 1996; 51: 10101016.

CG Watts , Establishing thresholds for influenza surveillance in Victoria. Australia and New Zealand Journal of Public Health 2003; 27: 409412.

MJ Fine , Validation of a pneumonia prognostic index using the MedisGroups comparative hospital database. American Journal of Medicine 1993; 94: 153159.

D Aronsky , Accuracy of administrative data for identifying patients with pneumonia. American Journal of Medical Quality 2005; 20: 319328.

D Aronsky , KJ Chan , PJ Haug . Evaluation of a computerized diagnostic decision support system for patients with pneumonia: study design considerations. Journal of the American Medical Informatics Association 2001; 8: 473485.

F Ansaldi , Effectiveness of a 23-valent polysaccharide vaccine in preventing pneumonia and non-invasive pneumococcal infection in elderly people: a large-scale retrospective cohort study. Journal of International Medical Research 2005; 33: 490500.

T Cherian , Standardized interpretation of paediatric chest radiographs for the diagnosis of pneumonia in epidemiological studies. Bulletin of the World Health Organization 2005; 83: 353359.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
Please enter your name
Please enter a valid email address
Who would you like to send this to? *