Key result
ICD-10-AM coding identified fewer cases of postoperative nausea and vomiting than electronic medication records (4.6% vs 11.6%), with poor agreement between the methods (Cohen's kappa 0.11).
Why the study?
There is no accepted gold standard for postoperative nausea and vomiting audits, and it was unknown whether ICD coding is equivalent to electronic medication records of antiemetic administration.
Is using ICD codes for Nausea and Vomiting an equivalent method of auditing postoperative nausea and vomiting rates, compared to using antiemetic administration in the 24 h post-surgery?
Observational (n=10,707)
No
Is using ICD codes for Nausea and Vomiting an equivalent method of auditing postoperative nausea and vomiting rates, compared to using antiemetic administration in the 24 h post-surgery?
Effect estimate: Cohen's kappa 0.11 (95% CI 0.087-0.14)
Absolute Event Rate: 4.6% vs 11.6%
ICD-10-AM coding poorly detects postoperative nausea and vomiting compared to electronic medication records of antiemetic administration, highlighting the need for improved coding definitions.
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Rescue antiemetic records may offer a scalable proxy for PONV audits; leaves open whether they reliably replace manual surveys across settings.
Jeavons-Fellows et al. (2025) conducted an observational in Postoperative nausea and vomiting (n=10,707). ICD-10-AM coding vs. Electronic medication records was evaluated on Agreement between PONV identified by ICD codes and electronic medication records over the 24-h period (Cohen's kappa 0.11, 95% CI 0.087-0.14). ICD-10-AM coding identified fewer cases of postoperative nausea and vomiting than electronic medication records (4.6% vs 11.6%), with poor agreement between the methods (Cohen's kappa 0.11).
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