Background
Methods
Data collection
ICD-9 code | Description |
---|---|
Regular codes | |
965.0 | Poisoning by opium (alkaloids), unspecified |
965.01 | Poisoning by heroin |
965.02 | Poisoning by methadone |
965.09 | Poisoning by other opiates and related narcotics |
965.1 | Poisoning by salicylates |
965.4
|
Poisoning by aromatic analgesics, not elsewhere classified
|
965.5 | Poisoning by pyrazole derivatives |
965.61 | Poisoning by propionic acid derivatives |
965.69 | Poisoning by other antirheumatics |
965.7 | Poisoning by other nonnarcotic analgesics |
965.8 | Poisoning by other specified analgesics and antipyretics |
965.9 | Poisoning by unspecified analgesics and antipyretics |
977.0 | Poisoning by dietetics |
977.1 | Poisoning by lipotropic drugs |
977.2 | Poisoning by antidotes and chelating agents, not elsewhere classified |
977.3 | Poisoning by alcohol deterrents |
977.4 | Poisoning by pharmaceutical excipients |
977.8 | Poisoning by other specified drugs and medicinal substances |
977.9 | Poisoning by unspecified drugs or medicinal substances |
Supplemental codes | |
E850.0 | Accidental poisoning by heroin |
E850.1 | Accidental poisoning by methadone |
E850.2 | Accidental poisoning by other opiates and related narcotics |
E850.3
|
Accidental poisoning by salicylates
|
E850.4
|
Accidental poisoning by aromatic analgesics, not elsewhere classified
|
E850.5 | Accidental poisoning by pyrazole derivatives |
E850.6 | Accidental poisoning by antirheumatics (antiphlogistics) |
E850.7
|
Accidental poisoning by other nonnarcotic analgesics
|
E850.8 | Accidental poisoning by other specified analgesics and antipyretics |
E850.9 | Accidental poisoning by unspecified analgesics or antipyretics |
E858.0 | Accidental poisoning by hormones and synthetic substitutes |
E858.1 | Accidental poisoning by primarily systemic agents |
E858.2 | Accidental poisoning by agents primarily affecting blood constituents |
E858.3 | Accidental poisoning by agents primarily affecting cardiovascular system |
E858.4 | Accidental poisoning by agents primarily affecting gastrointestinal system |
E858.5 | Accidental poisoning by water, mineral, and uric acid metabolism drugs |
E858.6 | Accidental poisoning by agents primarily acting on the smooth and skeletal muscles and respiratory system |
E858.7 | Accidental poisoning by agents primarily affecting skin and mucous membranes; ophthalmological, otorhinolaryngological, and dental drugs |
E858.8 | Accidental poisoning by other specified drugs |
E858.9 | Accidental poisoning by unspecified drugs |
E935.0 | Heroin causing adverse effects in therapeutic use |
E935.1 | Methadone causing adverse effects in therapeutic use |
E935.2 | Other opiates and related narcotics causing adverse effects in therapeutic use |
E935.3 | Salicylates causing adverse effects in therapeutic use |
E935.4 | Aromatic analgesics, not elsewhere classified, causing adverse effects in therapeutic use |
E935.5 | Pyrazole derivatives causing adverse effects in therapeutic use |
E935.6 | Antirheumatics [antiphlogistics] causing adverse effects in therapeutic use |
E935.7 | Other nonnarcotic analgesics causing adverse effects in therapeutic use |
E935.8 | Other specified analgesics and antipyretics causing adverse effects in therapeutic use |
E935.9 | Unspecified analgesics and antipyretics causing adverse effects in therapeutic use |
E950.0
|
Suicide and self-inflicted poisoning by analgesics, antipyretics, and antirheumatics
|
E950.5 | Suicide and self-inflicted poisoning by unspecified drugs or medicinal substances |
Chart review
Statistical analysis
Results
Identification of acetaminophen-related ED visits
Variable | No. | % |
---|---|---|
Age* | ||
0-5 years | 154 | 48.7 |
6-14 years | 71 | 22.5 |
15-24 years | 91 | 28.8 |
Female | 195 | 61.7 |
Ethnicity | ||
White | 133 | 42.1 |
Hispanic | 103 | 32.6 |
Black | 52 | 16.4 |
Asian | 11 | 3.5 |
Other/unknown | 17 | 5.4 |
ICD-9 code performance
Age category (Years) (Number of cases) | ICD-9 code | Total number of visits | Total number of cases | Sensitivity (%) | PPV (%) | False positive visits (%) |
---|---|---|---|---|---|---|
965.4 | 290 | 269 | 85.1% | 92.8% | 7.2% | |
E850.4 | 87 | 82 | 25.9% | 94.3% | 5.7% | |
E850.7 | 1 | 1 | 0.3% | 100.0% | 0.0% | |
All ages | E950.0 | 98 | 71 | 22.5% | 72.4% | 27.6% |
(N=316) | 965.4 OR E850.4 | 290 | 269 | 85.1% | 92.8% | 7.2% |
965.4 OR E950.0 | 319 | 275 | 87.0% | 86.2% | 13.8% | |
E850.4 OR E950.0 | 185 | 153 | 48.4% | 82.7% | 17.3% | |
965.4, E850.4 OR E950.0 | 319 | 275 | 87.0% | 86.2% | 13.8% | |
Age 0-5 | 965.4 | 140 | 133 | 86.4% | 95.0% | 5.0% |
E850.4 | 75 | 72 | 46.8% | 96.0% | 4.0% | |
(N=154) | 965.4 OR E850.4 | 140 | 133 | 86.4% | 95.0% | 5.0% |
965.4 | 62 | 57 | 80.3% | 91.9% | 8.1% | |
E850.3 | 3 | 2 | 2.8% | 66.7% | 33.3% | |
Age 6-14 | E850.4 | 9 | 7 | 9.9% | 77.8% | 22.2% |
(N=71) | E950.0 | 42 | 29 | 40.8% | 69.0% | 31.0% |
965.4 OR E850.3 | 65 | 59 | 83.1% | 90.8% | 9.2% | |
965.4 OR E850.4 | 62 | 57 | 80.3% | 91.9% | 8.1% | |
965.4 OR E950.0 | 78 | 61 | 85.9% | 78.2% | 21.8% | |
E850.3 OR E950.0 | 45 | 31 | 43.7% | 68.9% | 31.1% | |
E850.4 OR E950.0 | 51 | 36 | 50.7% | 70.6% | 29.4% | |
965.4, E850.3 OR E850.4 | 65 | 59 | 83.1% | 90.8% | 9.2% | |
965.4, E850.3 OR E950.0 | 81 | 63 | 88.7% | 77.8% | 22.2% | |
965.4, E850.4 OR E950.0 | 78 | 61 | 85.9% | 78.2% | 21.8% | |
E850.3 OR E850.4 OR E950.0 | 54 | 38 | 53.5% | 70.4% | 29.6% | |
965.4, E850.3, E850.4 OR E950.0 | 81 | 63 | 88.7% | 77.8% | 22.2% | |
965.4 | 88 | 79 | 86.8% | 89.8% | 10.2% | |
Age 15-24 | E850.4 | 3 | 3 | 3.3% | 100.0% | 0.0% |
(N=91) | E950.0 | 56 | 42 | 46.2% | 75.0% | 25.0% |
965.4 OR E850.4 | 88 | 79 | 86.8% | 89.8% | 10.2% | |
965.4 OR E950.0 | 101 | 81 | 89.0% | 80.2% | 19.8% | |
E850.4 OR E950.0 | 59 | 45 | 49.5% | 76.3% | 23.7% | |
965.4, E850.4 OR E950.0 | 101 | 81 | 89.0% | 80.2% | 19.8% |
Age category | Description | ICD-9 code | Visits | Cases | Unintentional, N (%; 95% CI) | Intentional, N (%; 95% CI) | Illicit unintended use, N (%; 95% CI) |
---|---|---|---|---|---|---|---|
Total | N=1,215 | N=316 | N=172 | N=139 | N=5 | ||
Poisoning | 965.4 | 290 | 269 | 146 (54.3; 48.1-60.3) | 119 (44.2; 38.2-50.4) | 4 (1.5; 0.4-3.8) | |
All ages |
Accidental
|
E850.4
| 87 | 82 |
75 (91.5; 83.2-96.5)
| 6 (7.3; 2.7-15.2) | 1 (1.2; 0.0-6.6) |
(N=316) |
Accidental
|
E850.7
| 1 | 1 |
1 (100.0; 2.5-100.0)
| 0 (0.0) | 0 (0) |
Suicide/self-inflicted
|
E950.0
| 98 | 71 | 1 (1.4; 0.0-7.6) |
70 (98.6; 92.4-100.0)
| 0 (0) | |
Age 0-5 | Poisoning | 965.4 | 140 | 133 | 133 (100; 97.3-100.0) | 0 (0) | 0 (0) |
(N=154) |
Accidental
|
E850.4
| 75 | 72 |
72 (100; 95.0-100.0)
| 0 (0) | 0 (0) |
Poisoning | 965.4 | 62 | 57 | 8 (14.0; 6.3-25.8) | 47 (82.5; 70.1-91.3) | 2 (3.5; 0.4-12.1) | |
Age 6-14 |
Accidental
| E850.3 | 3 | 2 |
1 (50.0; 1.3-98.7)
| 1 (50.0; 1.3-98.7) | 0 (0) |
(N=71) |
Accidental
| E850.4 | 9 | 7 |
3 (42.9; 9.9-81.6)
| 4 (57.1; 18.4-90.1) | 0 (0) |
Suicide/self-inflicted
| E950.0 | 42 | 29 | 0 (0) |
29 (100; 88.1-100.0)
| 0 (0) | |
Age 15-24 | Poisoning | 965.4 | 88 | 79 | 5 (6.3; 2.1-14.2) | 72 (91.1; 82.6-96.4) | 2 (2.5; 0.3-8.8) |
(N=91) |
Accidental
|
E850.4
| 3 | 3 |
0 (0)
| 2 (66.7; 9.4; 99.2) | 1 (33.3; 0.8-90.6) |
Suicide/self-inflicted
| E950.0 | 56 | 42 | 1 (2.4; 0.1-12.6) |
41 (97.6; 87.4-99.9)
| 0 (0) |