Assessment of the Diagnoses of Crohn's Disease and Ulcerative Colitis in a Danish Hospital Information System

Fonager, Kirsten; Sørensen, Henrik Toft; Rasmussen, Steen; Møller-Petersen, J; Vyberg, Mogens

doi:10.3109/00365529609031980

Cited by 235 publications

(169 citation statements)

References 15 publications

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“…The high validity of the diagnostic coding for IBD was further strengthened by our criteria for initiation of IBD pharmacotherapy. 31 To address differences in the distribution of age and sex between patients with IBD and the reference population, we performed a matched analysis, which yielded similar IBD-associated risk estimates and hereby supported the findings from our primary analysis. The diagnostic coding of HF in the Danish registries holds a high specificity of 99% but similar to the EuroHeart Failure survey program, the sensitivity of the HF diagnosis was low (30%-50%).…”

Section: Strengths and Limitationssupporting

confidence: 50%

Inflammatory Bowel Disease Is Associated With an Increased Risk of Hospitalization for Heart Failure

Kristensen

Ahlehoff

Lindhardsen

et al. 2014

Circ: Heart Failure

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Background-Inflammatory bowel disease (IBD) has been linked to adverse cardiovascular events, but a relation to heart failure (HF) is uncertain. We investigated the IBD-associated risk of HF in a nationwide setting. Methods and Results-A total of 5 436 647 Danish citizens, with no history of IBD or HF, were included on January 1, 1997, and followed up until first hospitalization for HF, death, or December 31, 2011. Of these subjects, 23 681 developed IBD for which disease activity was determined continuously throughout the study. The risk of hospitalization for HF was estimated with a Poisson regression model adjusting for comorbidity and cardiovascular pharmacotherapy as timedependent covariates. During a mean follow-up of 11.8 years in the reference population and 6.4 years in the IBD group, hospitalization for HF occurred in 553 subjects with IBD and 171 405 in the reference population. Patients with IBD had a 37% increased risk of hospitalization for HF (incidence rate ratio, 1.37; 95% confidence interval, 1.26-1.49) compared with the reference population. IBD activity-specific analyses showed markedly increased risk of HF hospitalization during flares (incidence rate ratio, 2.54; 95% confidence interval, 2.13-3.04) and persistent activity (incidence rate ratio, 2.73; 95% confidence interval, 2.25-3.33) but not in IBD remission (incidence rate ratio, 1.04; 95% confidence interval, 0.94-1.16). Conclusions-In a nationwide cohort, IBD was associated with an increased risk of hospitalization for HF, and this risk was strongly correlated to periods of active disease. The mechanisms underlying this finding warrant further studies.(Circ Heart Fail. 2014;7:717-722.)

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Section: Strengths and Limitationssupporting

confidence: 50%

Inflammatory Bowel Disease Is Associated With an Increased Risk of Hospitalization for Heart Failure

Kristensen

Ahlehoff

Lindhardsen

et al. 2014

Circ: Heart Failure

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“…Hence, we used the NPR to identify CD patients based on hospital discharge diagnoses and specific codes for surgical procedures for CD, (ii) the completeness and the validity of CD diagnoses in the NPR are of high quality. The completeness of diagnoses of CD has been examined in a Danish study using the pathology system as a reference standard 30 -showing that among all patients, with a confirmed diagnosis of CD, 94% were included in the NPR. 30 The overall validity of diagnosis of CD in the NPR was 97%, 30 (iii) there is no major misclassification between CD and ulcerative colitis patients.…”

Section: Discussionmentioning

confidence: 99%

Pre‐operative use of anti‐TNF‐α agents and the risk of post‐operative complications in patients with Crohn's disease – a nationwide cohort study

Nørgård

Nielsen

Qvist

et al. 2012

Aliment Pharmacol Ther

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“…Consequently, some of the patients included in the present series will probably have a preoperative diagnosis of indeterminate colitis, but since this diagnosis was first added to the ICD classification in 2009 and its validity is uncertain it was not included as a potential risk factor for pouch failure. While the validity of IBD diagnoses in the NPR has proven excellent [37], a protocolled assessment of all cases would be necessary to sufficiently classify patients as having 'indeterminate colitis' and determine the effect of this diagnosis on failure risk.…”

Section: Methodological Considerationsmentioning

confidence: 99%

Pouch failures following ileal pouch–anal anastomosis for ulcerative colitis

et al. 2018

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Aim Ileal pouch-anal anastomosis is a procedure offered to patients with ulcerative colitis who opt for restoration of bowel continuity. The aim of this study was to determine the risk of pouch failure and ascertain the risk factors associated with failure. MethodThe study included 1991 patients with ulcerative colitis who underwent ileal pouch-anal anastomosis in Denmark in the period 1980-2013. Pouch failure was defined as excision of the pouch or presence of an unreversed stoma within 1 year after its creation. We used Cox proportional hazards regression to explore the association between pouch failure and age, gender, synchronous colectomy, primary faecal diversion, annual hospital volume (very low, 1-5 cases per year; low, 6-10; intermediate 11-20; high > 20), calendar year, laparoscopy and primary sclerosing cholangitis.Results Over a median 11.4 years, 295 failures occurred, corresponding to 5-, 10-and 20-year cumulative risks of 9.1%, 12.1% and 18.2%, respectively. The risk of failure was higher for women [adjusted hazard ratio (aHR) 1.39, 95% CI 1.10-1.75]. Primary nondiversion (aHR 1.63, 95% CI 1.11-2.41) and a low hospital volume (aHR, very low volume vs high volume 2.30, 95% CI 1.26-4.20) were also associated with a higher risk of failure. The risk of failure was not associated with calendar year, primary sclerosing cholangitis, synchronous colectomy or laparoscopy.Conclusion In a cohort of patients from Denmark (where pouch surgery is centralized) with ulcerative colitis and ileal pouch-anal anastomosis, women had a higher risk of pouch failure. Of modifiable factors, low hospital volume and non-diversion were associated with a higher risk of pouch failure.

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Assessment of the Diagnoses of Crohn's Disease and Ulcerative Colitis in a Danish Hospital Information System

Abstract: The regional hospital system showed few misclassifications of the diagnoses of Crohn's disease and ulcerative colitis. Thus the nationwide hospital system (based on the regional hospital systems) may provide a unique study base for future research.

Cited by 235 publications

References 15 publications

Inflammatory Bowel Disease Is Associated With an Increased Risk of Hospitalization for Heart Failure

Inflammatory Bowel Disease Is Associated With an Increased Risk of Hospitalization for Heart Failure

Pre‐operative use of anti‐TNF‐α agents and the risk of post‐operative complications in patients with Crohn's disease – a nationwide cohort study

Pouch failures following ileal pouch–anal anastomosis for ulcerative colitis

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