@article{ref1,
title="An emergency department medical record review for adolescent intentional self-harm injuries",
journal="Injury epidemiology",
year="2021",
author="Costich, Julia and Zummer, Jaryd and Cooper, Gena and Slavova, Dessi and Hansen, Anna",
volume="8",
number="1",
pages="e3-e3",
abstract="BACKGROUND: Non-suicidal self-injury and suicide attempts are increasing problems among American adolescents. This study developed a definition for identifying  intentional self-harm (ISH) injuries in emergency department (ED) records coded with  International Classification of Diseases, 10th Revision, Clinical Modification  (ICD-10-CM) codes. The definition is based on the injury-reporting framework  proposed by the Centers for Disease Control and Prevention. The study sought to  estimate the definition's positive predictive value (PPV), and the proportion of ISH  injuries with intent to die (i.e., suicide attempt). <br><br>METHODS: The study definition,  based on first-valid external cause-of-injury ICD-10-CM codes X71-X83, T14.91,  T36-T65, or T71, captured 207 discharge records for initial encounters for ISH in  one Kentucky ED. Medical records were reviewed to confirm provider-documented  diagnosis for ISH, and identify intent to die or suicide ideation. The PPV of the  study definition for capturing provider-documented ISH injuries was reported with  its 95% confidence interval (95% CI). <br><br>RESULTS: The estimated PPV for the study  definition to capture ISH injuries was 88.9%, 95% CI (83.8%, 92.8%). The estimated  percentage of ISH with intent to die was 45.9, 95% CI (47.1, 61.0%). The ICD-10-CM  code &quot;suicide attempt&quot; (T14.91) captured only 7 cases, but coding guidelines  restrict assignment of this code to cases in which the mechanism of the suicide  attempt is unknown. <br><br>CONCLUSIONS: The proposed case definition supported a robust PPV  for ISH injuries. Our findings add to the evidence that the current ICD-10-CM coding  system and coding guidelines do not allow identification of ISH with intent to die;  modifications are needed to address this issue.<p /> <p>Language: en</p>",
language="en",
issn="2197-1714",
doi="10.1186/s40621-020-00293-8",
url="http://dx.doi.org/10.1186/s40621-020-00293-8"
}