标题：Discrepancy between admission diagnosis and discharge diagnosis in cardiovascular diseases: An analysis based on the groups of international classification disease, 10th revision
摘要：Introduction: There is a significant relationship between the appropriate treatment plansand accurate medical diagnosis. Admission and discharge diagnoses in hospitals are oftendifferent and this has significant implications on patient care and safety. The aim of thisstudy was to explore the discrepancies between the admission diagnosis and the dischargediagnosis.Methods: This was a longitudinal study conducted at Zanjan University of Medical Sciences(ZUMS). The study sample included admitted patients in hospitals during 2012-2019. TheICD-10 codes between I00 and I99 were selected as Cardiovascular Diseases. Data analysiswas conducted by R (v3.6.0) and Rstudio (v1.2.1335) software. Agreement analysis wasconducted by Cohen’s Kappa statistics, and Chi Square statistic was used for examining therelationships between categorical variables.Results: Agreement analysis of cardiovascular diseases subgroups showed that the values ofKappa coefficient range were varied between κ=0.34 for Chronic rheumatic heart diseasesand κ=0.93 for Acute rheumatic fever diseases. The values of the Kappa coefficient for the10 most common ICD-10 codes were in the range from κ=0. 44 for I25.9 to κ=0.77 for I80.2.Conclusion: The results of this study showed that there was a significant difference betweenADx and DDx, and the values of kappa coefficient were not the same between CVDssubgroups. There are definite needs for improvement on diagnostic accuracy, especially inregard to CVDs cases with acute condition.
