A systematic review of validated methods to capture myopericarditis using administrative or claims data

Idowu, Rachel; Carnahan, Ryan M.; Sathe, Nila A; McPheeters, Melissa L

doi:10.1016/j.vaccine.2013.08.074

Cited by 9 publications

(6 citation statements)

References 19 publications

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“…In the SLE cohort, patients with lupus nephritis (LN) were defined as having ≥ 2 ICD-9 hospital discharge diagnoses or physician billing claims for nephritis, proteinuria, and/or renal failure, occurring ≥ 30 days apart, on or after the SLE criteria were met 31,32 . CVD at baseline was defined as the presence of any of the following covariables during the baseline period: acute myocardial infarction, old myocardial infarction, angina, coronary atherosclerosis, percutaneous coronary intervention, coronary artery bypass graft, cerebrovascular accident, peripheral vascular disease, carotid artery stenosis, and heart failure [33][34][35][36][37][38][39][40] .…”

Section: Methodsmentioning

confidence: 99%

Atrial Fibrillation/flutter Hospitalizations among US Medicaid Recipients with and without Systemic Lupus Erythematosus

Chen

Barbhaiya²,

Solomon³

et al. 2019

J Rheumatol

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Objective Systemic lupus erythematosus (SLE) is a multisystem chronic inflammatory autoimmune disease with high prevalence of several risk factors for atrial fibrillation/flutter (AF). However, the incidence and risk of AF in SLE have not been well quantified. Methods We used the United States Medicaid Analytic eXtract from 2007 to 2010 to identify beneficiaries aged 18–65 years, with prevalent SLE, each matched by age and sex to 4 non-SLE general Medicaid recipients. We estimated the incidence rates (IR) per 1000 person-years (PY) for AF hospitalizations and used multivariable Cox regression to estimate the HR for AF hospitalization. Results We identified 46,876 US Medicaid recipients with SLE, and 187,504 age- and sex-matched non-SLE controls (93% female; mean age 41.5 ± 12.2 yrs). Known AF risk factors such as hypertension (HTN), cardiovascular disease (CVD), and kidney disease were more prevalent in patients with SLE. During a mean followup of 1.9 ± 1.1 years for SLE, and 1.8 ± 1.1 years for controls, the IR per 1000 PY for AF was 1.4 (95% CI 1.1–1.6) among patients with SLE and 0.7 (95% CI 0.6–0.8) among non-SLE controls. In age- and sex-matched and race-adjusted Cox models, the HR for AF was 1.79 (95% CI 1.43–2.24); after adjustment for baseline HTN and CVD, the adjusted HR was reduced to 1.17 (95% CI 0.92–1.48). Conclusion SLE was associated with a doubled rate of hospitalization for AF compared to age- and sex-matched general Medicaid patients. In a race-adjusted model, the risk was 80% higher. However, the AF risk factors HTN and CVD were more prevalent among patients with SLE and accounted for the excess risk.

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Section: Methodsmentioning

confidence: 99%

Atrial Fibrillation/flutter Hospitalizations among US Medicaid Recipients with and without Systemic Lupus Erythematosus

Chen

Barbhaiya²,

Solomon³

et al. 2019

J Rheumatol

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“…The primary outcomes were the first ICD-9 CM diagnosis code for the following acute cardiac manifestations of SLE: (1) pericarditis and/or myocarditis, defined as at least one ICD-9 CM diagnosis code for pericarditis (423.1, 423.9 and 420.xx) [14][15][16] or myocarditis (422.9x, 429.0); (2) endocarditis (424.91); or (3) valvular insufficiency (424.0-424.3, excluding rheumatic heart disease (394.1) and bacterial endocarditis (421.0-421.9)). 17 Secondary outcomes included diagnosis codes for cardiac tamponade (423.3) and procedure codes for pericardial drainage (ICD-9 PCS 37.0, CPT 33010, 33011, 33015, 33025).…”

Section: Study Measuresmentioning

confidence: 99%

Child-onset systemic lupus erythematosus is associated with a higher incidence of myopericardial manifestations compared to adult-onset disease

Chang

Xiao

Mercer‐Rosa

et al. 2018

Lupus

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Objectives: There are no population-based estimates of the incidence or risk factors for acute cardiac manifestations in children with systemic lupus erythematosus (SLE) to guide screening and diagnostic imaging practices. We estimated the incidence and prevalence of acute cardiac manifestations of child-onset SLE compared to adult-onset SLE and identified factors associated with cardiac diagnoses. Methods: We identified children (5–17 years) and adults (18–64) with incident SLE (≥3 ICD-9 codes 710.0, >30 days apart) using Clinformatics® DataMart (OptumInsight, Eden Prairie, MN) de-identified U.S. administrative claims (2000–2013). We calculated incidence and prevalence of three outcomes: ≥1 diagnosis code for 1) pericarditis and/or myocarditis, 2) endocarditis or 3) valvular insufficiency. Negative binomial regression was used to identify characteristics associated with cardiac diagnoses in children and determine whether SLE onset in childhood versus adulthood was independently associated with cardiac involvement. Results: There were 297 children and 6927 adults with new-onset SLE. 17.8% of children had ICD-9 codes for acute cardiac diagnoses, the incidence of which were highest in the first year after SLE diagnosis (12.2 per 100 person-years). African American race (incidence rate ratio (IRR) 6.6, 95% CI [2.9, 15.0], p<0.01) and nephritis (IRR 7.0, 95% CI [2.6, 18.6], p<0.01) were associated with acute cardiac diagnoses in children. Child-onset disease was independently associated with a 4.4-fold higher rate of pericarditis or myocarditis compared to adult-onset SLE after adjustment for other disease and demographic characteristics (95% CI [2.4, 8.0], p<0.01). Conclusion: This study establishes baseline estimates of the incidence and prevalence of pericarditis and myocarditis in child-onset SLE, which is substantially higher than that of adultonset SLE. Prospective echocardiographic evaluations are needed to validate incidence measures and characterize the natural history of acute cardiac manifestations in child-onset SLE, as well as identify risk factors for poor cardiac outcomes to inform screening and management.

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“…Acute cardiac manifestations were defined as a composite outcome of at least one ICD-9 diagnosis code for pericarditis (423.1, 423.9x and 420.xx), 13,14 myocarditis (422.9x, 429.0), endocarditis (424.91), or valvular insufficiency (424.0-424.3, excluding rheumatic heart disease (394.1) and bacterial endocarditis (421.0-421.9)). 15 As disease manifestations can precede the recognition of SLE by months to years, we included cardiac diagnoses occurring within 12 months preceding the first SLE code until the end of enrollment.…”

Section: Study Measures Acute Cardiac Manifestationsmentioning

confidence: 99%

Use of echocardiography at diagnosis and detection of acute cardiac disease in youth with systemic lupus erythematosus

Chang

Knight

Xiao

et al. 2018

Lupus

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Objectives There are no guidelines on the use of echocardiography to detect cardiac manifestations of childhood-onset systemic lupus erythematosus (SLE). We quantify the prevalence of acute cardiac disease in youth with SLE, describe echocardiogram utilization at SLE diagnosis, and compare regional echocardiogram use with incident cardiac diagnoses. Methods Using the Clinformatics® DataMart (OptumInsight, Eden Prairie, MN) de-identified United States administrative database from 2000 to 2013, we identified youth ages 5-24 years with new-onset SLE (≥3 ICD-9 SLE codes 710.0, > 30 days apart) and determined the prevalence of diagnostic codes for pericardial disease, myocarditis, endocarditis, and valvular insufficiency. Multiple logistic regression was used to identify factors associated with echocardiography during the baseline period, up to one year before or six months after SLE diagnosis. We calculated a regional echocardiogram utilization index, which is the ratio of observed use over the mean predicted probability based on all available baseline characteristics. Spearman's rank correlation coefficient was used to evaluate the association between regional echocardiogram utilization indices and percentage of imaged youth diagnosed with their first cardiac manifestation following echocardiography. Results Among 699 youth with new-onset SLE, 18% had ≥ 1 diagnosis code for acute cardiac disease, of which valvular insufficiency and pericarditis were most common. Twenty-five percent of all youth underwent echocardiogram during the baseline period. Regional echocardiogram use was positively correlated with the percentage of imaged youth found to have cardiac disease (ρ = 0.71, p = 0.05). There was up to a five-fold difference in adjusted odds of baseline echocardiography between low- and high-utilizing regions (OR = 0.19, p = 0.007). Conclusion Nearly one-fifth of youth with new-onset SLE have acute cardiac manifestations; however, use of echocardiograms at SLE diagnosis is highly variable. There may be incremental diagnostic value to early use of echocardiography, but prospective studies are needed to determine whether greater use of echocardiograms modifies outcomes.

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A systematic review of validated methods to capture myopericarditis using administrative or claims data

Cited by 9 publications

References 19 publications

Atrial Fibrillation/flutter Hospitalizations among US Medicaid Recipients with and without Systemic Lupus Erythematosus

Atrial Fibrillation/flutter Hospitalizations among US Medicaid Recipients with and without Systemic Lupus Erythematosus

Child-onset systemic lupus erythematosus is associated with a higher incidence of myopericardial manifestations compared to adult-onset disease

Use of echocardiography at diagnosis and detection of acute cardiac disease in youth with systemic lupus erythematosus

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