索赔数据中的静脉血栓塞栓症诊断定义:对研究的影响
Vanessa Vyas1, Ashlynn Fuccello1, Seana L Corbin1
1Department of Surgery, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA.
Journal of thrombosis and thrombolysis
|June 22, 2025
概括
选择国际疾病分类 (ICD) 代码显著影响 claims 数据中的静脉血栓栓塞 (VTE) 率和风险因素关联. 标准化VTE定义对于提高研究可重复性至关重要.
科学领域:
- 医疗信息学 医疗信息学
- 流行病学 流行病学
- 医疗数据分析 医学数据分析
背景情况:
- 静脉血栓塞栓症 (VTE) 是一个重要的术后并发症.
- 行政索赔中的VTE诊断数据依赖于国际疾病分类 (ICD) 代码.
- 跨研究的VTE定义的ICD代码选择的变化可能会导致不一致的发现.
研究的目的:
- 调查用于定义VTE的不同ICD代码集如何影响观察到的VTE率和索赔数据中的相关风险因素.
- 使用多个VTE定义,包括一个新提议的VTE定义,比较VTE率和相关变量.
主要方法:
- 从三项已发表的研究中提取了VTE的ICD代码,并制定了新的定义.
- 在IQVIA PharMetrics® Plus数据库的25%样本上使用标准化场景比较了四个不同的VTE定义.
- 分析了2122名接受胃肠道癌症手术的患者,重点是出院后90天的VTE.
- 使用双变量和多变量逻辑回归来评估VTE和患者/手术变量之间的关联.
主要成果:
- 在四个VTE定义中使用了116到304个ICD-9/10代码的大量范围.
- 根据使用的定义,VTE发病率从2.3%到4.4%不等.
- 静脉瘤与年龄,食道手术和胃手术之间的关联根据静脉瘤的定义有所不同.
- 埃利克沙瑟并发症评分和肝脏手术类型在定义中始终与VTE相关.
结论:
- 选择用于定义VTE的ICD代码显著影响索赔数据中报告的发病率和相关风险因素.
- 在VTE定义中的差异有助于研究结果的变化,并可能影响临床解释.
- 建议使用ICD代码来定义VTE的标准化方法,以提高利用行政索赔数据的研究的可靠性和可重复性.
相关概念视频
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
42
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
42
Venous Thrombosis III: Interprofessional Care
28
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
28
Venous Thrombosis I: Introduction
47
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
47
Venous Thrombosis IV: Nursing Management
27
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
27
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
48
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
48
Pulmonary Embolism I: Introduction
50
Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
50


