Abstract
Objective
We sought to develop and validate a list of ICD-10-CM codes identifying abusive head
trauma (AHT).
Methods
Subjects included all children under 2 years with head trauma seen in the emergency
department or admitted to one of 5 medical centers. Cases were classified as AHT,
accidental head injury, or indeterminate based on chart review of the medical record.
ICD-10-CM code list to identify cases of AHT was developed based on prior head injury
code lists. Sensitivity and specificity of the final code list were calculated.
Results
There were 2883 patients in the study population of whom 524 had AHT, 2123 had accidental
injury, and 236 were indeterminate cases. The final list of AHT codes had a sensitivity
of 76.1% (95% CI 72.5–79.8) and a specificity of 98.5% (95% CI 98.0–99.0) when limiting
analyses to the groups with identified cause of injury (accidental vs abusive). Misclassification
of cases based on codes resulting in false positives and false negatives was due to
coding errors.
Conclusions
The list of ICD-10-CM codes can be utilized to identify and track cases of AHT at
a national level in large administrative datasets though likely underestimates true
injury burden.
Keywords
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Article info
Publication history
Published online: December 26, 2022
Accepted:
December 17,
2022
Received:
August 26,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Conflicts of Interest: All authors report providing expert testimony, as part of their clinical responsibilities, in cases of alleged maltreatment.
Identification
Copyright
Copyright © 2022 by Academic Pediatric Association
