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

Epidemiol Infect. 2008 Feb;136(2):232-40. doi: 10.1017/S0950268807008564. Epub 2007 Apr 20.


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 > or = 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.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Australia / epidemiology
  • Female
  • Hospitals
  • Humans
  • International Classification of Diseases / statistics & numerical data*
  • Male
  • Medical Records / statistics & numerical data
  • Pneumonia / epidemiology*
  • Population Surveillance / methods*
  • Predictive Value of Tests
  • Radiography, Thoracic / statistics & numerical data
  • Sensitivity and Specificity