Validation of ICD-10 codes shows intracranial venous thrombosis incidence to be higher than previously reported.
BACKGROUND
Intracranial venous thrombosis (ICVT) accounts for around 0.5% of all stroke cases. There have been no previously published studies of the International Classification of Diseases, Tenth Edition (ICD-10) validation for the identification of ICVT admissions in adults.


OBJECTIVE
The aims of this study were to validate and quantify the performance of the ICD-10 coding system for identifying cases of ICVT in adults and to derive an estimate of incidence.


METHOD
Administrative data were collected for all patients admitted to a regional neurosciences centre over a 5-year period. We searched for the following ICD-10 codes at any position: G08.X (intracranial and intraspinal phlebitis and thrombophlebitis), I67.6 (non-pyogenic thrombosis of intracranial venous system), I63.6 (cerebral infarction due to cerebral venous thrombosis, non-pyogenic), O22.5 (cerebral venous thrombosis in pregnancy) and O87.3 (cerebral venous thrombosis in the puerperium).


RESULTS
Sixty-five admissions were identified by at least one of the relevant ICD-10 codes. The overall positive predictive value (PPV) for confirmed ICVT from all of the admissions combined was 92.3% (60 out of 65) with the results for each code as follows: G08.X 91.5% (54 of 59), O22.5 100% (4 of 4), I67.6 100% (1 of 1), I63.6 100% (1 of 1) and O87.3 100% (1 of 1). There were 40 unique cases of ICVT over a 5-year period giving an annual incidence of ICVT of 5 per million.


CONCLUSIONS
All codes gave a high PPV.


IMPLICATIONS FOR PRACTICE
As demonstrated in previous studies, the incidence of ICVT may be higher than previously thought.
['Handley|Joel D|JD|https://orcid.org/0000-0001-9586-5653', 'Emsley|Hedley Ca|HC|']
D000328:Adult D000368:Aged D004739:England D005260:Female D006801:Humans D015994:Incidence D038801:International Classification of Diseases D020767:Intracranial Thrombosis D008297:Male D008875:Middle Aged D020246:Venous Thrombosis
ICD-10 venous thrombosis incidence cerebral thrombosis clinical coding sinus thrombosis