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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:
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