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Influenza infection Secondary care

Chukwuma Iwundu, Clare MacRae, Eleftheria Vasileiou

Type
Disease or syndrome
ID
PH807
Version ID
2231
Valid event data range
01/01/2001 to 31/01/2021
Sex
Female/Male
Agreement Date
2021-12-10
Coding system
ICD10 codes ICD9 codes ICD11 codes
Tags /Collections
BREATHE Phenotype Library

Definition

  • Not found code search
  • Wabe et al, 2021The aim of the study was to evaluate the accuracy of assigned International Classification of Diseases version 10-Australian Modification (ICD-10-AM) codes for influenza by comparing with patients’ results of their polymerase chain reaction (PCR)-based laboratory tests.Although ICD-10-AM coding for influenza demonstrated high accuracy when laboratory results were received before discharge, its sensitivity was substantially lower for patients whose test results were not available at discharge. The timely availability of laboratory test results during the episode of care could contribute to improved coding accuracy.The timely availability of laboratory test results during the episode of care could contribute to improved coding accuracy.Feemster et al, 2012We used Pediatric Health Information System data and laboratory records from 3 children's hospitals to determine whether administrative data accurately identify children with laboratory-confirmed influenza.The objective of this multicenter study was to validate influenza-specific ICD-9 codes for the identification of influenza cases among hospitalized childrenAmong 23 282 inpatients, diagnosis codes for influenza detected 73% of laboratory-confirmed influenza cases, whereas <1% of patients without a diagnosis code had laboratory-confirmed influenza.Keren et al, 2006To determine the sensitivity and positive predictive value of influenza-specific ICD-9 admission or discharge codes (487.0, 487.1, and 487.8), we conducted a retrospective cohort study of all patients <21 years of age hospitalized at the Children's Hospital of Philadelphia with laboratory-confirmed influenza during 3 consecutive influenza seasons (July 2001 through June 2004)Influenza-specific ICD-9 codes assigned in a setting of routine rapid diagnostic testing may be useful for following trends. However, these codes will substantially underestimate the actual number of influenza-related hospitalizations.

Implementation

These codes are not intended to be mandatory, but are to be used as a starting point for the identification of influenza infection in routine Electronic Health Record (EHR). Each study may differ in the sensitivity and specificity of the coding required.

According to the National Health Service (NHS), Influenza is a common infectious viral illness spread by coughs and sneezes. Some of the main symptoms of influenza include: high temperature (fever) of 38C or above, tiredness and weakness, headache, general aches and pains and dry or chesty cough. Cold-like symptoms, such as a blocked or runny nose, sneezing, and a sore throat, can also be caused by influenza, but they tend to be less severe than the other symptoms.

https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/flu

According to the National Institute for Health and Care Excellence (NICE) guidelines, Influenza is an acute respiratory illness caused by RNA viruses f the family Orthomyxoviridae (influenza viruses). There are three types of influenza virus: Influenza A occurs more frequently and is more virulent. It is responsible for local outbreaks, larger epidemics and pandemics. Influenza B often co-circulates with influenza A during the yearly outbreaks. Generally, influenza B causes less severe clinical illness, although it can still be responsible for outbreaks. Influenza C usually causes a mild or asymptomatic infection similar to the common cold.

Influenza presents with symptoms appearing around 2 days after exposure. Uncomplicated influenza signs and symptoms include: coryza, nasal discharge, cough, fever, gastrointestinal symptoms, headache, malaise, myalgia, arthralgia, ocular symptoms, and sore throat. Complicated influenza is defined by signs and symptoms that: require hospital admission, involve the lower respiratory tract, central nervous system, or cause significant exacerbation of an underlying medical condition.

https://cks.nice.org.uk/topics/influenza-seasonal/

Not found code search


Publications

  • Publications in 2020-2021 identified in PubMed

  • Moss JWE, Davidson C, Mattock R, Gibbons I, Mealing S, Carroll S. Quantifying the direct secondary health care cost of seasonal influenza in England. BMC Public Health. 2020 Sep 29;20(1):1464. doi: 10.1186/s12889-020-09553-0. PMID: 32993588; PMCID: PMC7526100.

  • Ramsay J, Minton J, Fischbacher C, Fenton L, Kaye-Bardgett M, Wyper GMA, Richardson E, McCartney G. How have changes in death by cause and age group contributed to the recent stalling of life expectancy gains in Scotland? Comparative decomposition analysis of mortality data, 2000-2002 to 2015-2017. BMJ Open. 2020 Oct 7;10(10):e036529. doi: 10.1136/bmjopen-2019-036529. PMID: 33033012; PMCID: PMC7542937.

  • Wabe N, Li L, Lindeman R, Post JJ, Dahm MR, Li J, Westbrook JI, Georgiou A. Evaluation of the accuracy of diagnostic coding for influenza compared to laboratory results: the availability of test results before hospital discharge facilitates improved coding accuracy. BMC Med Inform Decis Mak. 2021 May 22;21(1):168. doi: 10.1186/s12911-021-01531-9. PMID: 34022851; PMCID: PMC8141245.

  • Fitzpatrick T, Malcolm W, McMenamin J, Reynolds A, Guttmann A, Hardelid P. Community-Based Antibiotic Prescribing Attributable to Respiratory Syncytial Virus and Other Common Respiratory Viruses in Young Children: A Population-Based Time-series Study of Scottish Children. Clin Infect Dis. 2021 Jun 15;72(12):2144-2153. doi: 10.1093/cid/ciaa403. PMID: 32270199.

  • Code repositories

  • ID- 1 - Repository- Manchester Clinical Codes - Description- Trends in antibiotic prescribing in primary care for clinical syndromes subject to national recommendations to reduce antibiotic resistance, UK 1995-2011: analysis of a large database of primary care consultations - Conditions- URTI - Publication- https://doi.org/10.1093/jac/dku291 - Clinical codes- Read Version 2

  • ID- 2 - Repository- HDR UK National Phenomics Resource Project - Description- A chronological map of 308 physical and mental health conditions from 4 million individuals in the English National Health Service - Conditions- Infections of other or unspecified organs - Publication- https://doi.org/10.1016/S2589-7500(19)30012-3 - Clinical codes- ICD-10

  • ID- 3 - Repository- HDR UK National Phenomics Resource Project - Description- A chronological map of 308 physical and mental health conditions from 4 million individuals in the English National Health Service - Conditions- Lower respiratory tract infections - Publication- https://doi.org/10.1016/S2589-7500(19)30012-3 - Clinical codes- ICD-10

  • ID- 4 - Repository- HDR UK National Phenomics Resource Project - Description- A chronological map of 308 physical and mental health conditions from 4 million individuals in the English National Health Service - Conditions- Viral diseases (excl chronic hepatitis/HIV) - Publication- https://doi.org/10.1016/S2589-7500(19)30012-3 - Clinical codes- ICD-10

  • ID- 5 - Repository- HDR UK National Phenomics Resource Project - Description- Incidence of Community-Acquired Lower Respiratory Tract Infections and Pneumonia among Older Adults in the United Kingdom: A Population-Based Study - Conditions- Pneumonia - Publication- https://doi.org/10.1371/journal.pone.0075131 - Clinical codes- ICD-10

  • ID- 6 - Repository- OpenSAFELY - Description- Codes indicating a diagnosis of influenza or influenza-like illness - Conditions- Documented influenza illness - Publication- - Clinical codes- CTV3 (Read V3) with TPP extensions

  • ID- 7 - Repository- OpenSAFELY - Description- Codes indicating a diagnosis of a lower respiratory tract infection excluding pneumonia - Conditions- Lower respiratory tract infection - Publication- - Clinical codes- CTV3 (Read V3) with TPP extensions

  • ID- 8 - Repository- OpenSAFELY - Description- Pneumonia ICD-10 codes - Conditions- Pneumonia secondary care - Publication- - Clinical codes- ICD-10

  • ID- 9 - Repository- LSHTM Data Compass - Description- Code list: ICD-10 codes for pneumonia - Conditions- Pneumonia - Publication- https://doi.org/10.17037/DATA.00000847 - Clinical codes- ICD-10

  • ID- 10 - Repository- LSHTM Data Compass - Description- Clinical codelist: Read codes and terms used for pneumonia (CPRD) - Conditions- Pneumonia - Publication- https://doi.org/10.17037/DATA.00001654 - Clinical codes- Medcodes

Clinical Code List

Rows: 13
Code Description BREATHE recommended
1 E30 Influenza due to identified seasonal influenza virus Y
1 E31 Influenza due to identified zoonotic or pandemic influenza virus Y
1 E32 Influenza, virus not identified Y
1D01.00 Meningitis due to Haemophilus influenzae N
1E30&XN5SG Influenza due to identified seasonal influenza virus / Influenza virus Y
1G40&XN1P6 Sepsis without septic shock / Haemophilus influenzae N
CA40.02 Pneumonia due to Haemophilus influenzae N
CA40.12 Pneumonia due to parainfluenza virus N
CA40.1Z Viral pneumonia, unspecified N
CA42.3 Acute bronchitis due to Parainfluenza virus N
CA42.4 Acute bronchitis due to Haemophilus influenzae N
QC01.8 Need for immunization against influenza N
XN1P6 Haemophilus influenzae N
Rows: 6
Code Description BREATHE recommended Iuliano et al, 2018 Ebell et al, 2015 Goto et al, 2014 Feemster et al, 2012 Pitman et al, 2007 Keren et al, 2006
487.0 Influenza Y Y Y
487.1 Influenza with other respiratory manifestations Y Y y Y Y Y Y
487.8 Influenza with other manifestations Y Y Y Y Y Y Y
488.0 Influenza due to certain identified influenza viruses Y Y Y
488.1 Influenza due to identified 2009 h1n1 influenza virus Y Y Y Y
488.8 Influenza due to novel influenza a Y Y Y
Rows: 16
Code Description BREATHE recommended Wabe et al, 2021 Fitzpatrick et al, 2021 Moss et al, 2020 Ramsay et al, 2020 Verfurden et al , 2020 Iuliano et al, 2018 Ho et al, 2018 Bennett et al, 2018 Acciai et al, 2017 Hardelid et al, 2017 Matias et al, 2016 ONS, 2016 Fleming et al, 2016 Cromer et al, 2014 Auger et al, 2014 Green et al, 2013 Henderson et al, 2006 HDR UK National Phenomics Resource Project 2 HDR UK National Phenomics Resource Project 3 HDR UK National Phenomics Resource Project 4 HDR UK National Phenomics Resource Project 5 Open Safely 8 LSHTM Data Compass 9
A41.3 Sepsis due to Haemophilus influenzae
A49.2 Haemophilus influenzae infection, unspecified site
J09 Influenza due to certain identified influenza viruses Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
J10 Influenza due to other identified influenza virus Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
J10.0 Influenza with pneumonia, seasonal influenza virus identified Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
J10.1 Influenza with other respiratory manifestations, seasonal influenza virus identified Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
J10.8 Influenza with other manifestations, seasonal influenza virus identified Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
J11 Influenza due to unidentified influenza virus Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
J11.0 Influenza with pneumonia, virus not identified Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y