Chart validation of inpatient International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) administrative diagnosis codes for venous thromboembolism (VTE) among intravenous immune globulin (IGIV) users in the Sentinel Distributed Database

Ammann, Eric M.; Cuker, Adam; Carnahan, Ryan M.; Perepu, Usha; Winiecki, Scott K.; Schweizer, Marin L.; Leonard, Charles E.; Fuller, Candace C.; Garcia, Crystal; Haskins, Cole B.; Chrischilles, Elizabeth A.

doi:10.1097/md.0000000000009960

Cited by 21 publications

(22 citation statements)

References 21 publications

(14 reference statements)

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“…Outcomes were assessed within 30 days of COVID‐19 diagnosis by relevant ICD‐10 and/or procedure codes for hospitalization, intensive care unit (ICU) admission, mechanical ventilation, acute renal failure requiring the initiation of renal replacement therapy, ischemic stroke, venous thromboembolism including pulmonary embolism and deep venous thrombosis, death, and a composite outcome of ICU admission, mechanical ventilation, or death (Supplementary Table 2, available on the Arthritis & Rheumatology website at http://onlinelibrary.wiley.com/doi/10.1002/art.41619/abstract) (9,10).…”

Section: Methodsmentioning

confidence: 99%

COVID‐19 Outcomes in Patients With Systemic Autoimmune Rheumatic Diseases Compared to the General Population: A US Multicenter, Comparative Cohort Study

D’Silva

Jorge

Cohen

et al. 2021

Arthritis & Rheumatology

136

128

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Objective. Patients with systemic autoimmune rheumatic diseases (ARDs) continue to be concerned about risks of severe coronavirus disease 2019 outcomes. This study was undertaken to evaluate the risks of severe outcomes in COVID-19 patients with systemic ARDs compared to COVID-19 patients without systemic ARDs.Methods. Using a large multicenter electronic health record network, we conducted a comparative cohort study of patients with systemic ARDs diagnosed as having COVID-19 (identified by diagnostic code or positive molecular test result) compared to patients with COVID-19 who did not have systemic ARDs, matched for age, sex, race/ethnicity, and body mass index (primary matched model) and additionally matched for comorbidities and health care utilization (extended matched model). Thirty-day outcomes were assessed, including hospitalization, intensive care unit (ICU) admission, mechanical ventilation, acute renal failure requiring renal replacement therapy, ischemic stroke, venous thromboembolism, and death.Results. We initially identified 2,379 COVID-19 patients with systemic ARDs (mean age 58 years; 79% female) and 142,750 comparators (mean age 47 years; 54% female). In the primary matched model (2,379 patients with systemic ARDs and 2,379 matched comparators with COVID-19 without systemic ARDs), patients with systemic ARDs had a significantly higher risk of hospitalization (relative risk [RR] 1.14 [95% confidence interval (95% CI) 1.03-1.26]), ICU admission (RR 1.32 [95% CI 1.03-1.68]), acute renal failure (RR 1.81 [95% CI 1.07-3.07]), and venous thromboembolism (RR 1.74 [95% CI 1.23-2.45]) versus comparators but did not have a significantly higher risk of mechanical ventilation or death. In the extended model, all risks were largely attenuated, except for the risk of venous thromboembolism (RR 1.60 [95% CI 1.14-2.25]). Conclusion.Our findings indicate that COVID-19 patients with systemic ARDs may be at a higher risk of hospitalization, ICU admission, acute renal failure, and venous thromboembolism when compared to COVID-19 patients without systemic ARDs. These risks may be largely mediated by comorbidities, except for the risk of venous thromboembolism.

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Section: Methodsmentioning

confidence: 99%

COVID‐19 Outcomes in Patients With Systemic Autoimmune Rheumatic Diseases Compared to the General Population: A US Multicenter, Comparative Cohort Study

D’Silva

Jorge

Cohen

et al. 2021

Arthritis & Rheumatology

136

128

View full text Add to dashboard Cite

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“…The use of electronic records can be subjected to misclassification errors. In support of the validity of our study, it is worth mentioning that ICD-9 codes have demonstrated a high accuracy for the identification of cirrhosis [33], HCC [34] and VTE [35,36]. To reduce coding errors, we included only VTE cases listed as primary and secondary discharge diagnoses, most likely representing acute events, and excluded cases of superficial venous thrombosis and catheter-related venous thrombosis.…”

Section: Discussionmentioning

confidence: 88%

Risk factors for portal vein thrombosis or venous thromboembolism in a large cohort of hospitalized cirrhotic patients

et al. 2022

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Background Portal vein thrombosis (PVT) and venous thromboembolism (VTE) are fearsome complications of liver cirrhosis. Objectives To assess the prevalence and the main risk factors for venous thrombotic complications in hospitalized cirrhotic patients. Patients/methods We retrospectively reviewed electronic administrative discharge data of 19461 cirrhotic patients hospitalized over a 35-year period; univariate and multivariate logistic regression was used to asses risk factors for PVT or VTE and their impact on hospital stay and mortality. Results 382 out of 7445 patients (5.1%) were diagnosed with PVT and 95 (1.3%) with VTE. Liver cirrhosis complications were observed in 45% of patients. Hepatic encephalopathy (HE) (OR 13.88 [10.76–17.98] p < 0.0001), endoscopic signs of portal hypertension (OR 1.33 [1.02–1.75] p = 0.02), hepatocellular carcinoma (HCC) (OR 4.59 [3.6–5.84] p < 0.0001), diabetes (OR 1.68 [1.27–2.22] p = 0.0001), abdominal surgery/invasive procedures (OR 2.03 [1.56–2.64] p < 0.0001) emerged as independent predictors of PVT. Higher risk of VTE was observed in patients with HE (OR 3.21 [1.78–5.79] p < 0.0001), HCC (OR 1.98 [1.23–3.19] p = 0.002) or other tumors (OR 2.48 [1.42–4.32] p = 0.001), acute illnesses (infections OR 3.01 [1.84–5.05] p = 0.0001; cardiac/respiratory insufficiency OR 2.4 [1.27–4.53] p = 0.003; acute myocardial infarction/stroke OR 7.86 [1.76–35.12] p = 0.003). VTE was the only independent predictor of in-hospital mortality (OR 4.45 [1.05–18.81] p = 0.042). Conclusions Liver disease complications related to portal hypertension, HCC or other tumors, diabetes, acute illnesses (i.e. infections, cardiac/pulmonary insufficiency, acute myocardial infarction/stroke) and abdominal interventions are associated with increased risk of PVT or VTE in hospitalized cirrhotic patients, and should be considered to define personalized preemptive approaches.

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“…Outcomes were identified using ICD-10-CM codes from previously validated ICD diagnosis lists [16][17][18][19][20]). While MI, ischemic stroke, and PE were ascertained from ICD codes restricted to the inpatient setting, acute DVT was identified via ICD code from either the inpatient or emergency department setting since uncomplicated DVTs may be treated in the emergency department setting without hospitalization (see Supplement for more details).…”

Section: Discussionmentioning

confidence: 99%

COVID-19 is associated with higher risk of venous thrombosis, but not arterial thrombosis, compared with influenza: Insights from a large US cohort

Ward¹,

Sarraju

Lee³

et al. 2021

Preprint

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Introduction Infection with SARS-CoV-2 is typically compared with influenza to contextualize its health risks. SARS-CoV-2 has been linked with coagulation disturbances including arterial thrombosis, leading to considerable interest in antithrombotic therapy for Coronavirus Disease 2019 (COVID-19). However, the independent thromboembolic risk of SARS-CoV-2 infection compared with influenza remains incompletely understood. We evaluated the adjusted risks of thromboembolic events after a diagnosis of COVID-19 compared with influenza in a large retrospective cohort. Methods We used a US-based electronic health record (EHR) dataset linked with insurance claims to identify adults diagnosed with COVID-19 between April 1, 2020 and October 31, 2020. We identified influenza patients diagnosed between October 1, 2018 and April 31, 2019. Primary outcomes [venous composite of pulmonary embolism (PE) and acute deep vein thrombosis (DVT); arterial composite of ischemic stroke and myocardial infarction (MI)] and secondary outcomes were assessed 90 days post-diagnosis. Propensity scores (PS) were calculated using demographic, clinical, and medication variables. PS-adjusted hazard ratios (HRs) were calculated using Cox proportional hazards regression. Results There were 417,975 COVID-19 patients (median age 57y, 61% women), and 345,934 influenza patients (median age 47y, 66% women). Compared with influenza, patients with COVID-19 had higher venous thromboembolic risk (HR 1.53, 95% CI 1.38-1.70), but not arterial thromboembolic risk (HR 1.02, 95% CI 0.95-1.10). Secondary analyses demonstrated similar risk for ischemic stroke (HR 1.11, 95% CI 0.98-1.25) and MI (HR 0.93, 95% CI 0.85-1.03) and higher risk for DVT (HR 1.36, 95% CI 1.19-1.56) and PE (HR 1.82, 95% CI 1.57-2.10) in patients with COVID-19. Conclusion In a large retrospective US cohort, COVID-19 was independently associated with higher 90-day risk for venous thrombosis, but not arterial thrombosis, as compared with influenza. These findings may inform crucial knowledge gaps regarding the specific thromboembolic risks of COVID-19.

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Chart validation of inpatient International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) administrative diagnosis codes for venous thromboembolism (VTE) among intravenous immune globulin (IGIV) users in the Sentinel Distributed Database

Abstract: Supplemental Digital Content is available in the text

Cited by 21 publications

References 21 publications

COVID‐19 Outcomes in Patients With Systemic Autoimmune Rheumatic Diseases Compared to the General Population: A US Multicenter, Comparative Cohort Study

COVID‐19 Outcomes in Patients With Systemic Autoimmune Rheumatic Diseases Compared to the General Population: A US Multicenter, Comparative Cohort Study

Risk factors for portal vein thrombosis or venous thromboembolism in a large cohort of hospitalized cirrhotic patients

COVID-19 is associated with higher risk of venous thrombosis, but not arterial thrombosis, compared with influenza: Insights from a large US cohort

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