Validation of hospital discharge coding for neonatal abstinence syndrome.
Acta Paediatr
; 108(10): 1786-1792, 2019 10.
Article
em En
| MEDLINE
| ID: mdl-30924956
ABSTRACT
AIM:
To validate the diagnostic discharge coding of neonatal abstinence syndrome (NAS) (International Classification of Diseases [ICD]-10-AM, P96.1).METHODS:
Retrospective record review of infants diagnosed with NAS (P96.1) in a non-tertiary Australian hospital between 2000 and 2016. NAS criteria were predetermined to include the following (i) maternal opioid use; (ii) infant requiring NAS medication and (iii) at least one score of ≥8 on the Finnegan Neonatal Abstinence Scoring Tool (FNAST).RESULTS:
Of the 253 infants coded with P96.1, 82/146 (56%) opioid-exposed infants and 9/107(18%) infants exposed to non-opioid drugs only received withdrawal medication sensitivity 56.2 (95% confidence interval 47.7-64.3), specificity 91.6 (84.2-95.8%), positive predictive value (PPV) 90.1 (81.6-95.1%) and negative predictive value (NPV) 60.5 (52.5-68.0%) for all three criteria. Using the criterion of ≥1 FNAST score ≥8 resulted in 58.0 (51.3-64.4%) sensitivity, 63.6 (40.8-82.0%) specificity, 94.4 (88.8-97.4%) PPV and 12.6 (7.3-20.6%) NPV for identifying need for NAS medications.CONCLUSION:
A diagnosis of P96.1 is highly specific and predictive but poorly sensitive for identifying opioid-exposed infants requiring medications for withdrawal.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Síndrome de Abstinência Neonatal
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Codificação Clínica
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Male
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Newborn
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Pregnancy
Idioma:
En
Revista:
Acta Paediatr
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Austrália