Results from a study of International Classification of Diseases (ICD)-10 codes suggest that researchers and clinicians should be cautious when interpreting data from heart failure analyzes that rely on ICD-10 codes.
Data from the study, led by Marc Bonaca, MD, PhD, University of Colorado Aurora Health, presented at the 2023 American Heart Association (AHA) Scientific Sessions, demonstrate varying degrees of concordance between left ventricular ejection response and cardiac ICD-10 failure to hospitalization. .
“I think the lesson is that you have to be very careful with real-world data,” Bonacca explained in an interview. HCP Real-Time Cardiology. “We have to realize that CPT codes or billing codes, ICD codes are for billing, not for science. That doesn’t mean they’re useless, but when you look at it, you have to really verify that you’re Does what you sample over time reflect what you want to sample.”
In the interest of examining the specificity of ICD-10 codes for case identification, Bonaca and a team of colleagues designed the current study to evaluate the relationship between left ventricular ejection fraction and assigned ICD-10 codes using a real-world data set. A cross-sectional analysis of patients admitted with a primary diagnosis of heart failure between January 1, 2018, and October 1, 2022 resulted in a cohort of 61,238 patients hospitalized for heart failure. Of these, 49,772 had available data on left ventricular ejection fraction.
For analysis purposes, the researchers defined it as having one of the following ICD-10 codes: I50.2, systolic heart failure; I50.3, diastolic heart failure; I50.4, combined systolic and diastolic heart failure ; I11.0, hypertensive heart disease with heart failure; I13.0 and I13.2, hypertensive heart disease with heart failure and chronic kidney disease.
Upon analysis, the results showed that the majority of patients admitted for systolic heart failure and systolic and diastolic heart failure had an LVEF of 40% or less (86.2% and 74.8%, respectively). The researchers noted that a similar trend was observed among patients admitted for diastolic heart failure, with 94.0% of patients in this group having an ejection fraction of 50% or greater.
In contrast, there was a greater degree of variability in the distribution of ejection fractions in patients hospitalized for hypertensive heart disease with heart failure and hypertensive heart disease with heart failure and chronic kidney disease (36.3% and 52.9% of the cohort, respectively).
To gain a deeper understanding of the study’s results and how it can inform future research efforts, the HCPLive Cardiology editorial team sat down with Bonaca to learn more. A portion of that interview can be found below.
Bonaca’s relevant disclosures include Medtronic, Pfizer, Abbott Laboratories, Adamis Pharmaceuticals Corporation, Agios Pharmaceuticals, Inc. and others.
refer to:
- Gluckman T, Chiu ST, Rider D, et al. Relationship between left ventricular ejection fraction and ICD-10 codes in patients hospitalized for heart failure. Paper presented at: 2023 American Heart Association Scientific Sessions; November 10-13; Philadelphia, PA. Accessed: November 10, 2023.