Table 6

PPV for TBI based on a review of ED records with skull fracture ICD-10-CM codes*, by study site

Study sitesOne shock trauma, one ED in referral centres
(Maryland)
n=428
Two EDs in university system
(Kentucky)
n=385
EDs in level I, II, III trauma hospitals
(Colorado)
n=368*
EDs in all acute care hospitals
(Massachusetts)
n=388
Level of certainty of TBICount%Count%Count%Count%
Highest‡23254.221956.928677.725966.8
Medium122.8164.2256.85915.2
Lowest4711.04110.7215.74010.3
Highest + medium levels24457.023561.031184.531882.0
All levels of certainty29168.027671.733290.235892.3
No TBI documentation11125.910928.3369.8307.7
  • *Skull fracture ICD-10-CM diagnosis codes beginning with ‘S02.0’, ‘S02.1’, ‘S02.8’ or ‘S02.91’ in any diagnosis field and seventh character of ‘A’ ‘B’ or missing. The billing record could not also have an intracranial injury code beginning with ‘S06’.

  • †The proportion of highest certainty of TBI is statistically significant by study site. Χ2=57.0761, p<0.0001.

  • ‡Seventeen of the 385 sampled medical records in Colorado indicated that the patient was not a state resident, was not discharged home, did not have an injury event or was admitted as an inpatient and are excluded.

  • ED, emergency department; ICD-10-CM, International Classification of Diseases, Tenth Revision, Clinical Modification; TBI, traumatic brain injury.