An algorithm to identify incident myocardial infarction using Medicaid data
| Autor: | Christianne L. Roumie, Patricia Gideon, Robert L. Huang, Lisa A. Kaltenbach, Edward F. Mitchel, Marie R. Griffin, Shannon M. Stratton, Neesha N. Choma |
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| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Pediatrics Epidemiology Myocardial Infarction Chest pain Cohort Studies Internal medicine medicine Humans Pharmacology (medical) cardiovascular diseases Myocardial infarction Stroke Aged Retrospective Studies Aged 80 and over Aspirin Medicaid business.industry Incidence Incidence (epidemiology) Anti-Inflammatory Agents Non-Steroidal Confounding Retrospective cohort study Middle Aged medicine.disease Tennessee United States Female medicine.symptom business Algorithms Cohort study medicine.drug |
| Zdroj: | Pharmacoepidemiology and Drug Safety. 18:1064-1071 |
| ISSN: | 1099-1557 1053-8569 |
| DOI: | 10.1002/pds.1821 |
| Popis: | Purpose Studies of non-steroidal anti-inflammatory drugs (NSAIDs) and cardiovascular events using administrative data require identification of incident acute myocardial infarctions (AMIs) and information on whether confounders differ by NSAID status. Methods We identified patients with a first AMI hospitalization from Tennessee Medicaid files as those with primary ICD-9 discharge diagnosis 410.x and hospitalization stay of > 2 calendar days. Eligible persons were non-institutionalized, aged 50–84 years between 1999–2004, had continuous enrollment and no AMI, stroke, or non-cardiovascular serious medical illness in the prior year. Of 5524 patients with a potential first AMI, a systematic sample (n = 350) was selected for review. Using defined criteria, we classified events using chest pain history, EKG, and cardiac enzymes, and calculated the positive predictive value (PPV) for definite or probable AMI. Results 337 of 350 (96.3%) charts were abstracted and 307 (91.1%), 6 (1.8%), and 24 (7.1%) events were categorized as definite, probable, and no AMI, respectively. PPV for any definite or probable AMI was 92.8% (95% CI 89.6–95.2); for an AMI without an event in the past year 91.7% (95% CI 88.3–94.2), and for an incident AMI was 72.7% (95% CI 67.7–77.2). Age-adjusted prevalence of current smoking (46.4% vs. 39.1%, p = 0.35) and aspirin use (36.9% vs. 35.9%, p = 0.90) was similar among NSAID users and non-users Conclusions ICD-9 code 410.x had high predictive value for identifying AMI. Among those with AMI, smoking and aspirin use was similar in NSAID exposure groups, suggesting these factors will not confound the relationship between NSAIDs and cardiovascular outcomes. Copyright © 2009 John Wiley & Sons, Ltd. |
| Databáze: | OpenAIRE |
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