Background: Use of International Classification of Disease (ICD) codes for traumatic brain injury (TBI) in healthcare administrative databases may underestimate the epidemiology of TBI. The present study examined the use of ICD-10 codes in a population-based New Zealand sample. Methods: TBI related ICD-codes within the New Zealand health database were examined for all incident cases from a population-based TBI sample (n = 1,369). Impact of age, gender, ethnicity, presence/absence of skull fracture, where the case was located (i.e., hospital) on receipt of an ICD code was examined. Results: Individuals who received a TBI-related ICD-code accounted for 18.6% of the studied population. The most frequent codes were brief loss of consciousness, head injury not otherwise specified, and concussion. Receipt of a code was not impacted by gender. Those with skull fracture (χ2 (1) = 69.983, p < 0.001), and/or attending hospital (χ2 (2) = 81.507, p < 0.001), and of older age (χ2 (1) = 56.473, p < 0.001) were more likely to receive a code. Conclusions: Reported incidence of TBI, when based upon health registration data, is likely to be a significant underestimate. Specific research needs to be conducted to identify the barriers to medical personnel implementing the ICD head injury codes and to identify ways in which the use of the codes can be improved.

Keywords:
TBI, Surveillance, ICD-10, Incidence
1.
World Health Organization: World Health Organization: International Classification of Diseases (ICD). 2016. http://www.who.int/classifications/icd/en/.
2.
Department of Health and Human Services: ICD-10-CM/PCS: The Next Generation of Coding. 2016. http://www.cms.gov/Medicare/Coding/ICD10/downloads/ICD-10Overview.pdf.
3.
American Medical Association: The Differences between ICD-9 and ICD-10. http://www.ama-assn.org/ama1/pub/upload/mm/399/icd10-icd9-differences-fact-sheet.pdf.
4.
Center for Disease Control and Prevention, Classification of Diseases, Functioning, and Disability: International Classification of Diseases, Ninth Revision (ICD-9). http://www.cdc.gov/nchs/icd/icd9.htm.
5.
Canadian Institute for Health Information: The Canadian Enhancement of ICD-10. http://www.cihi.ca/CIHI-ext-portal/pdf/internet/PDF_CODINGCLASS_ICD10ENHAN_EN.
6.
Tagliaferri F, Compagnone C, Korsic M, Servadei F, Kraus J: A systematic review of brain injury epidemiology in Europe. Acta Neurochir (Wien) 2006;148:255-268; discussion 268.
7.
Roozenbeek B, Maas AI, Menon DK: Changing patterns in the epidemiology of traumatic brain injury. Nat Rev Neurol 2013;9:231-236.
8.
Shore AD, McCarthy ML, Serpi T, Gertner M: Validity of administrative data for characterizing traumatic brain injury-related hospitalizations. Brain Inj 2005;19:613-621.
9.
Carroll CP, Cochran JA, Guse CE, Wang MC: Are we underestimating the burden of traumatic brain injury? Surveillance of severe traumatic brain injury using centers for disease control international classification of disease, ninth revision, clinical modification, traumatic brain injury codes. Neurosurgery 2012;71:1064-1070; discussion 1070.
10.
Deb S: ICD-10 codes detect only a proportion of all head injury admissions. Brain Inj 1999;13:369-373.
11.
Feigin VL, Theadom A, Barker-Collo S, et al: Incidence of traumatic brain injury in New Zealand: a population-based study. Lancet Neurol 2013;12:53-64.
12.
Theadom A, Barker-Collo S, Feigin VL, et al: The spectrum captured: a methodological approach to studying incidence and outcomes of traumatic brain injury on a population level. Neuroepidemiology 2012;38:18-29.
13.
Teasdale G, Jennett B: Assessment of coma and impaired consciousness. A practical scale. Lancet 1974;2:81-84.
14.
Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro CA: Mild traumatic brain injury in U.S. soldiers returning from Iraq. N Engl J Med 2008;358:453-463.
15.
Management of Concussion/mTBI Working Group: VA/DoD clinical practice guideline for management of concussion/mild traumatic brain injury. J Rehabil Res Dev 2009;46:CP1-CP68.
16.
Kokotailo RA, Hill MD: Coding of stroke and stroke risk factors using international classification of diseases, revisions 9 and 10. Stroke 2005;36:1776-1781.
17.
Feigin VL, Lawes CM, Bennett DA, Anderson CS: Stroke epidemiology: a review of population-based studies of incidence, prevalence, and case-fatality in the late 20th century. Lancet Neurol 2003;2:43-53.
18.
Feigin VL, Lawes CM, Bennett DA, Barker-Collo SL, Parag V: Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. Lancet Neurol 2009;8:355-369.
19.
Corrigan JD, Selassie AW, Orman JA: The epidemiology of traumatic brain injury. J Head Trauma Rehabil 2010;25:72-80.
20.
Andelic N: The epidemiology of traumatic brain injury. Lancet Neurol 2013;12:28-29.
© 2016 S. Karger AG, Basel
2016
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.