Validation of novel identification algorithms for major adverse cardiovascular events in a Japanese claims database

Shima, Daisuke; Ii, Yoichi; Higa, Shingo; Kohro, Takahide; Hoshide, Satoshi; Kono, Ken; Fujimoto, Shigeru; Niijima, Satoshi; Tomitani, Naoko; Kario, Kazuomi

doi:10.1111/jch.14151

Cited by 16 publications

(18 citation statements)

References 27 publications

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“…[2][3][4][5][6][7][8] Secondary outcome Secondary outcome variables were classi ed postoperatively as follows: cardiovascular complications: composed of Acute myocardial infarction (STEMIs & NSTEMIs), new congestive heart failure, non-fatal cardiac arrest and death within 7 days postoperatively. [9][10][11][12]…”

Section: Primary Outcomementioning

confidence: 99%

“…Acute kidney injury (AKI) commonly occurs in patients after noncardiac surgery and in 17.9% of patients following major surgery. [1][2][3][4][5][6][7][8][9] The mortality rate of patients experiencing AKI increases signi cantly. [3][4][5] Many risk factors such as body mass index (BMI), gender, age, African American race, preexisting hypertension, active congestive heart failure, chronic kidney disease, pulmonary disease, insulin-dependent diabetes mellitus, peripheral vascular disease, presence of ascites and complexity of the surgery advanced age cannot be modi ed.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the Effects of Different Regional Blockade Techniques on Occurrence of Acute Kidney Injury (AKI) After Major Thoracic and Abdominal Surgeries Under General Anesthesia: A Propensity Matching Analysis

Zhang¹,

Zhou²,

Liu³

2021

Preprint

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Background: Recently, it has been under consideration that the anesthetic techniques used during general anesthesia may have influence over the development of acute kidney injury and other postoperative outcomes. For this reason, we aimed to compare the effects of different regional blockade techniques (peripheral nerve blockade versus neuraxial epidural) on occurrence of acute kidney injury (AKI) after thoracic and abdominal surgeries under general anesthesia.Methods: In a single-center retrospective cohort study, 2846 patients undergoing elective thoracic or abdominal surgery during a period of seven years were included into the study. The primary endpoint was the occurrence of AKI postoperatively within a seven-day period in-hospital. Perioperative data were obtained and analyzed to provide data for secondary endpoints that include all other outcome related parameters. To reduce the influence of potential confounding factors, propensity score (PS) analysis was performed. Multivariate logistic regression models examined the selection of an epidural or PNB in general anesthesia before and after propensity score weighting analysis.Results: Of the 2846 patients, 7.3% (207 cases) suffered AKI. The odds ratio of AKI for PNB (epidural as reference) was 0.61 (0.40~0.83), P = 0.006. After propensity score matching, the odds ratio for PNB was [0.49 (0.28~0.70), P = 0.001]. All other outcome related parameters were considered and evaluated.Conclusions: After PS matching analysis, there is no difference in secondary outcome analysis of groups that received PNB or epidural neuraxial blockade who were both under general anesthesia. However, patients who received PNB under general anesthesia showed lower incidence of AKI within seven days postoperatively.

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Section: Primary Outcomementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of the Effects of Different Regional Blockade Techniques on Occurrence of Acute Kidney Injury (AKI) After Major Thoracic and Abdominal Surgeries Under General Anesthesia: A Propensity Matching Analysis

Zhang¹,

Zhou²,

Liu³

2021

Preprint

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“…18 MACEs have been extensively used as a cardiovascular outcome after particular medical management or after undergoing certain procedures. 19 Also, recent evidence has shown that periodontal disease inflammation is an independent predictor of the risk of MACEs, sug-gesting that arterial inflammation is the link behind this association. 20 Our study hypothesis (alternative) is that, given the smaller size of the penile vessels, the diagnosis of ED and periodontitis can be predictive and additive factors for future MACEs.…”

Section: Introductionmentioning

confidence: 99%

“…The definition varies between studies, referring to a bigger composite endpoint, including heart failure, acute coronary syndrome (stable and unstable), coronary artery bypass grafting, or percutaneous coronary intervention 18 . MACEs have been extensively used as a cardiovascular outcome after particular medical management or after undergoing certain procedures 19 . Also, recent evidence has shown that periodontal disease inflammation is an independent predictor of the risk of MACEs, suggesting that arterial inflammation is the link behind this association 20 …”

Section: Introductionmentioning

confidence: 99%

Patients with periodontitis and erectile dysfunction suffer a greater incidence of major adverse cardiovascular events: A prospective study in a Spanish population

Mesa

Arrabal-Polo

Magán‐Fernández

et al. 2022

Journal of Periodontology

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Background: Periodontitis and erectile dysfunction (ED) have been linked with cardiovascular disease. The association of periodontitis and ED with the occurrence of major adverse cardiovascular events has not been previously assessed.The aim of this study was to determine if the presence of periodontitis and ED has any effect on the incidence of major adverse cardiovascular events.Methods: Male patients that attended the Urology service were enrolled in a prospective study. Erectile dysfunction was diagnosed according to the International Index of Erectile Function. Sociodemographic data and periodontal clinical parameters were gathered (pocket probing depth, clinical attachment loss, bleeding on probing (BoP), plaque index and number of teeth) at baseline. Major adverse cardiovascular events occurred both before and during the follow-up time were registered. Bivariate analyses, as well as a multivariate analysis were performed, adjusting for potential confounders. Results: A total of 158 patients were included, with a mean follow-up of 4.2 years.A greater number of major adverse cardiovascular events occurred in the group that presented periodontitis and ED (P = 0.038). After adjusting by age and previous cardiovascular disease in the multivariate analysis, the annual major adverse cardiovascular event rate was estimated to be 3.7 times higher in the same group (P = 0.049). Other periodontal clinical variables together with ED supported these results and were close to statistical significance. Conclusions: Patients with periodontitis and ED, adjusted by age and a cardiovascular disease, showed 3.7 times more risk of suffering major adverse cardiovascular events after mean follow-up of 4.2 years.

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“…For codes with low accuracy, researchers should make study inclusion decisions based on the combination of the diagnostic codes and clinical evidence, such as related treatments for stroke. Shima et al 15 also reported that the positive predictive values (PPVs) for outcome identification algorithms were increased when event-specific treatment data for ischemic stroke were added to the algorithm based on diagnostic codes alone. However, there is few evidence regarding the validity of identification algorithms consisting of ICD-10 diagnostic codes in combination with other measures for hospitalized patients with AIS 16,17 in administrative databases, such as diagnostic imaging, drug administration, mechanical thrombectomy, or rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

Validity of identification algorithms combining diagnostic codes with other measures for acute ischemic stroke in MID‐NET®

Tanigawa

Kohama

Nonaka

et al. 2022

Pharmacoepidemiology and Drug

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Purpose: We aimed to develop a reliable identification algorithm combining diagnostic codes with several treatment factors for inpatients with acute ischemic stroke (AIS) to conduct pharmacoepidemiological studies using the administrative database MID-NET ® in Japan. Methods:We validated 11 identification algorithms based on 56 different diagnostic codes (International Classification of Diseases, Tenth Revision; ICD-10) using Diagnosis Procedure Combination (DPC) data combined with information on AIS therapeutic procedures added as "AND" condition or "OR" condition. The target population for this study was 366 randomly selected hospitalized patients with possible cases of AIS, defined as relevant ICD-10 codes and diagnostic imaging and prescription or surgical procedure, in three institutions between April 1, 2015 and March 31, 2017. We determined the positive predictive values (PPVs) of these identification algorithms based on comparisons with a gold standard consisting of chart reviews by experienced specialist physicians. Additionally, the sensitivities of them among 166 patients with the possible cases of AIS at a single institution were evaluated.Results: The PPVs were 0.618 (95% confidence interval [CI]: 0.566-0.667) to 0.909 (95% CI: 0.708-0.989) and progressively increased with adding or limiting information on AIS therapeutic procedures as "AND" condition in the identification algorithms. The PPVs for identification algorithms based on diagnostic codes I63.x were >0.8. However, the sensitivities progressively decreased to a maximum of $0.2 after adding information on AIS therapeutic procedures as "AND" condition. Conclusions:The identification algorithms based on the combination of appropriate ICD-10 diagnostic codes in DPC data and other AIS treatment factors may be useful to studies for AIS at a national level using MID-NET ® .

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Validation of novel identification algorithms for major adverse cardiovascular events in a Japanese claims database

Cited by 16 publications

References 27 publications

Comparison of the Effects of Different Regional Blockade Techniques on Occurrence of Acute Kidney Injury (AKI) After Major Thoracic and Abdominal Surgeries Under General Anesthesia: A Propensity Matching Analysis

Comparison of the Effects of Different Regional Blockade Techniques on Occurrence of Acute Kidney Injury (AKI) After Major Thoracic and Abdominal Surgeries Under General Anesthesia: A Propensity Matching Analysis

Patients with periodontitis and erectile dysfunction suffer a greater incidence of major adverse cardiovascular events: A prospective study in a Spanish population

Validity of identification algorithms combining diagnostic codes with other measures for acute ischemic stroke in MID‐NET®

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