ArticlePharmacoepidemiology and drug safety2026
Development and Validation of Case-Finding Algorithms to Identify Periprosthetic Joint Infections After Total Hip Arthroplasty in Veterans Health Administration Data.
Article in Pharmacoepidemiology and drug safety, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo determine the positive predictive values (PPVs) of ICD-9- and ICD-10-based diagnostic coding algorithms to identify periprosthetic joint infection (PJI) following total hip arthroplasty (THA) within the United States (US) Veterans Health Administration (VHA).
methodsWe selected patients with: (1) any position hospital discharge ICD-9 or ICD-10 diagnosis of PJI, (2) ICD-9, ICD-10, or current procedural terminology (CPT) procedure codes for THA any time prior to PJI diagnosis, (3) CPT code for hip X-ray within ±90 days of the PJI diagnosis, and (4) 1 or more CPT codes for arthrocentesis, arthrotomy, or revision arthroplasty all occurring within ±90 days of the PJI diagnosis date. We obtained separate samples of patients for ICD-9 and ICD-10-based PJI diagnoses. These samples were stratified by THA medical center volume. Infectious disease physicians adjudicated each identified PJI event. The PPV (95% confidence interval [CI]) for the ICD-9 and ICD-10 PJI algorithms were calculated.
resultsAmong the 90 sampled hip PJI events for the ICD-9 era, 79 were confirmed PJIs (PPV 87.8%, 95% CI 79.2%-93.7%). For the 90 sampled hip PJI events for the ICD-10 era, 72 were confirmed PJIs (PPV 80.0%, 95% CI 70.3%-87.7%).
conclusionThese algorithms yielded a PPV of 87.8% (ICD-9) and 80.0% (ICD-10), for confirmed PJI events and could be considered for use in future pharmacoepidemiologic studies.
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