Cases of iatrogenic pneumothorax can be identified from icd-9-cm coded data

Banafsheh Sadeghi, Ruth Baron, Patricia Zrelak, Garth H Utter, Jeffrey J. Geppert, Daniel J Tancredi, Patrick S Romano

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Hospital administrative data are being used to identify hospitals with hospital-acquired complications such as iatrogenic pneumothorax. This was a retrospective cross-sectional study of hospitalization records to estimate the positive predictive value (PPV) of the Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicator for iatrogenic pneumothorax. A probability sample of inpatient medical records from 2006 to 2007 was reviewed in a national sample of 28 volunteer hospitals. Among the 200 flagged cases, the PPV was 78% (95% confidence interval = 73%-82%). False positive cases were mostly a result of exclusionary conditions (11%) and pneumothoraxes that were present on admission (7%). About 44% of events followed attempted central venous catheter (CVC) placement. Of the 69 CVCassociated events, only 5 occurred with ultrasound guidance. AHRQ's iatrogenic pneumothorax indicator can serve in quality of care improvement. At least 1725 hospital-acquired pneumothoraxes could have been prevented in 2004 through universal use of ultrasound guidance during internal jugular cannulation.

Original languageEnglish (US)
Pages (from-to)218-224
Number of pages7
JournalAmerican Journal of Medical Quality
Issue number3
StatePublished - May 2010


  • Agency for Healthcare Research and Quality
  • Iatrogenic pneumothorax
  • ICD-9-CM data
  • Patient safety indicators

ASJC Scopus subject areas

  • Health Policy


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