Abstract Details

Title How Reliable Are the ICD9-CM Billing Codes in the Administrative Data To Estimate the Risk of Seizures and Epilepsy after Stroke?

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P05 - (-)

Poster/Presentation
Number 247

Objective

Background BACKGROUND: A prospective study found that first-ever post stroke seizures occurred in 8.9% of patients within 2 weeks of acute stroke. Retrospective studies have found rates from 2 to 6%.

Design/Methods DESIGN/METHODS: We used ICD9 discharge codes for seizures (780.3x) and epilepsy (345.xx) to identify possible seizures occurring during hospitalization for acute stroke using the Montefiore Stroke Registry from January 2009- December 2011.

Results RESULTS: Among 3003 confirmed stroke cases, 241 (8.0%) had a primary or secondary ICD9 code for seizure or epilepsy, out of which chart review confirmed that a seizure occurred during hospitalization or there was a history of epilepsy in 212 cases (88%). A first-ever seizure occurred in 93 cases (3.1%), among whom 39 (42%) were coded as epilepsy and 54 (58%) as seizure. There was a history of epilepsy prior to stroke in 119 cases (4.0%), among whom 99 (83%) were coded as epilepsy and 20 (17%) as seizure. Another 29 cases (1.0%) did not have a seizure during hospitalization or history of epilepsy prior to stroke, among whom 14 (48%) had a code for epilepsy and 15 (52%) for seizure.

Conclusions CONCLUSIONS: Among patients with acute stroke, secondary ICD9 codes identified 3.1% with first-ever stroke-related seizures, a figure only slightly lower than identified in other retrospective studies. The codes correctly identified that a seizure had occurred at some point in time almost 90% of the time; however the assignment of codes for seizure versus epilepsy was erratic, perhaps due to the common use of the term "seizure disorder" for epilepsy. It appears that administrative databases may be used as an effective screen for acute post-stroke seizures but chart review remains necessary for confirmation.

Authors/Disclosures
Indira De Jesus-Alvelo, MD (Indira De Jesus LLC) PRESENTER	Dr. De Jesus-Alvelo has nothing to disclose.
Daniel L. Labovitz, MD	An immediate family member of Dr. Labovitz has received personal compensation for serving as an employee of Herrick Feinstein.
Timothy Lesnick	No disclosure on file

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