Journal of cardiovascular electrophysiology · 2026
Association of Diagnostic Code Priority With Identification of True Cardiac Arrest in Patients Presenting to the Emergency Department.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Gohel Paulomi, Naniwadekar Aditi, Kancharla Krishna, Bhonsale Aditya, Mulukutla Suresh, Thoma Floyd, Voigt Andrew, Shalaby Alaa, Mark Estes N A, Jain Sandeep K, Saba Samir
Аннотация
BACKGROUND: Sudden cardiac arrest (SCA), a leading cause of mortality, is administratively coded as ventricular tachycardia (VT), ventricular fibrillation (VF), or unspecified SCA. Diagnostic codes are widely used in research, yet their accuracy in reflecting true SCA events is uncertain. The objective of this study is to evaluate the relationship between administrative diagnostic code rank (listing order) and the likelihood of true SCA in patients presenting to the emergency department (ED).
METHODS: From a database of 22 369 patients with VT/VF/SCA, we randomly selected 380 patients for detailed chart review. Diagnostic accuracy was confirmed when patients (1) had sustained a true VT/VF/SCA event during the index hospitalization and (2) when the event was not precipitated by non-cardiac causes.
RESULTS: Manual chart review for the 380 patients (age 71 ± 12 years, 53% women) confirmed that 65% experienced true VT/VF/SCA and 55% had an arrest unrelated to non-cardiac causes. Diagnostic accuracy was 100% at priority rank #1 and declined significantly at lower ranks. In the overall larger cohort of 22 369 patients, recurrence of VT/VF/SCA trended 3% lower (p = 0.086) and all-cause mortality was 5% higher (p < 0.001) with each diagnostic priority rank decrease, over a mean follow-up of 1.5 years.
CONCLUSION: Diagnostic codes show variable predictive accuracy for true VT/VF/SCA events, with the highest accuracy at priority rank #1. Higher-priority codes identify patients most likely to have true SCA, while lower-priority codes capture sick patients with other in-hospital events. These results have important implications for the interpretation of administrative health datasets.
METHODS: From a database of 22 369 patients with VT/VF/SCA, we randomly selected 380 patients for detailed chart review. Diagnostic accuracy was confirmed when patients (1) had sustained a true VT/VF/SCA event during the index hospitalization and (2) when the event was not precipitated by non-cardiac causes.
RESULTS: Manual chart review for the 380 patients (age 71 ± 12 years, 53% women) confirmed that 65% experienced true VT/VF/SCA and 55% had an arrest unrelated to non-cardiac causes. Diagnostic accuracy was 100% at priority rank #1 and declined significantly at lower ranks. In the overall larger cohort of 22 369 patients, recurrence of VT/VF/SCA trended 3% lower (p = 0.086) and all-cause mortality was 5% higher (p < 0.001) with each diagnostic priority rank decrease, over a mean follow-up of 1.5 years.
CONCLUSION: Diagnostic codes show variable predictive accuracy for true VT/VF/SCA events, with the highest accuracy at priority rank #1. Higher-priority codes identify patients most likely to have true SCA, while lower-priority codes capture sick patients with other in-hospital events. These results have important implications for the interpretation of administrative health datasets.