Validity of Administrative ICD-10 Diagnosis Codes for Ventricular Arrhythmia and Cardiac Arrest in a French University Hospital
- 1Pharmacoepidemiology Unit, Department of Clinical Pharmacology, Amiens-Picardie University Medical Center, Amiens, France.
- 2Department of Medical Information, Amiens-Picardie University Medical Center, Amiens, France.
- 3MP3CV Laboratory, Jules Verne University of Picardie, Amiens, France.
Abstract
Purpose
Drug-induced QT interval prolongation increases the risk of ventricular arrhythmias and cardiac arrest. Assessing these outcomes in electronic health databases and evaluating their association with drug exposure requires prior validation of administrative diagnostic codes. This study aimed to evaluate the positive predictive value (PPV) of International Classification of Diseases, 10th revision (ICD-10) codes for ventricular arrhythmias and cardiac arrest in the French hospital discharge summary database (Programme de Médicalisation des Systèmes d'Information (PMSI)).Methods
In a retrospective validation study, we examined PMSI data recorded at Amiens University Medical Center (Amiens, France). Hospital stays between September 2022 and August 2025 with ICD-10 codes for cardiac arrest (I46.0, I46.9), ventricular tachycardia (I47.2), or ventricular fibrillation/flutter (I49.0) were identified. Events were confirmed by electronic medical record review. PPVs with 95% confidence intervals (CI) were calculated. The study design prevented the estimation of sensitivity, specificity, and negative predictive values. Sensitivity analyses were stratified by year, and by type of care unit. Exposure to QT-prolonging medications prior to events was also assessed.Results
In a population of 182 patients (median age: 66 years; 75% males; in-hospital mortality rate: 45%), PPVs [95% CI] for all diagnosis codes were high: 0.98 [0.95; 1.00] for cardiac arrest with successful resuscitation, 0.96 [0.79; 1.00] for unspecified cardiac arrest, 0.99 [0.94; 1.00] for ventricular tachycardia, and 0.93 [0.87; 0.97] for ventricular fibrillation/flutter. Sensitivity analyses yielded consistent results. Overall, 49.7% of patients had been exposed to ≥1 QT-prolonging medications prior to a validated event, and 26.5% to ≥2 of these medications concomitantly.Conclusion
The high PPVs in PMSI data supports the use of the evaluated ICD-10 codes for outcome identification in pharmacoepidemiological studies of electronic health databases in general, and those investigating QT-prolonging medication use and the risk of serious cardiac events in particular.
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BibTeX
@article{pluquet2026validity,
title = {{Validity of Administrative ICD-10 Diagnosis Codes for Ventricular Arrhythmia and Cardiac Arrest in a French University Hospital}},
author = {Maxime Pluquet and Thibaut Balcaen and Solène M Laville and Sophie Liabeuf},
journal = {Clinical Epidemiology},
year = {2026},
month = oct,
doi = {10.2147/clep.s634107},
url = {https://u-picardie.hal.science/hal-05807142v1},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Validity of Administrative ICD-10 Diagnosis Codes for Ventricular Arrhythmia and Cardiac Arrest in a French University Hospital
AU - Maxime Pluquet
AU - Thibaut Balcaen
AU - Solène M Laville
AU - Sophie Liabeuf
PY - 2026
DA - 2026/10/16
JO - Clinical Epidemiology
DO - 10.2147/clep.s634107
UR - https://u-picardie.hal.science/hal-05807142v1
AB - Purpose Drug-induced QT interval prolongation increases the risk of ventricular arrhythmias and cardiac arrest. Assessing these outcomes in electronic health databases and evaluating their association with drug exposure requires prior validation of administrative diagnostic codes. This study aimed to evaluate the positive predictive value (PPV) of International Classification of Diseases, 10th revision (ICD-10) codes for ventricular arrhythmias and cardiac arrest in the French hospital discharge summary database (Programme de Médicalisation des Systèmes d'Information (PMSI)).Methods In a retrospective validation study, we examined PMSI data recorded at Amiens University Medical Center (Amiens, France). Hospital stays between September 2022 and August 2025 with ICD-10 codes for cardiac arrest (I46.0, I46.9), ventricular tachycardia (I47.2), or ventricular fibrillation/flutter (I49.0) were identified. Events were confirmed by electronic medical record review. PPVs with 95% confidence intervals (CI) were calculated. The study design prevented the estimation of sensitivity, specificity, and negative predictive values. Sensitivity analyses were stratified by year, and by type of care unit. Exposure to QT-prolonging medications prior to events was also assessed.Results In a population of 182 patients (median age: 66 years; 75% males; in-hospital mortality rate: 45%), PPVs [95% CI] for all diagnosis codes were high: 0.98 [0.95; 1.00] for cardiac arrest with successful resuscitation, 0.96 [0.79; 1.00] for unspecified cardiac arrest, 0.99 [0.94; 1.00] for ventricular tachycardia, and 0.93 [0.87; 0.97] for ventricular fibrillation/flutter. Sensitivity analyses yielded consistent results. Overall, 49.7% of patients had been exposed to ≥1 QT-prolonging medications prior to a validated event, and 26.5% to ≥2 of these medications concomitantly.Conclusion The high PPVs in PMSI data supports the use of the evaluated ICD-10 codes for outcome identification in pharmacoepidemiological studies of electronic health databases in general, and those investigating QT-prolonging medication use and the risk of serious cardiac events in particular.
SN - 1179-1349
ER -