Post-Thrombotic Syndrome and Chronic Pulmonary Embolism after Obstetric Venous Thromboembolism

2021 ◽  
Author(s):  
Fergal O'Shaugnessy ◽  
Shravya Govindappagari ◽  
Yongmei Huang ◽  
Sbaa K. Syeda ◽  
Mary E. D'Alton ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
General Population ◽  
Insurance Coverage ◽  
International Classification Of Diseases ◽  
Entire Cohort ◽  
Post Thrombotic Syndrome ◽  
Key Points ◽  
Classification Of Diseases ◽  
Chronic Pulmonary Embolism

Objective While the majority of venous thromboembolism (VTE) during pregnancy events resolve with anticoagulation, long-term complications may occur including (1) post-thrombotic syndrome and (2) chronic pulmonary embolism. The objective of this study was to determine risk of these two complications. Study Design A retrospective cohort study using the MarketScan databases was performed on deliveries from 2008 to 2014. We identified women aged 15 to 54 years diagnosed with acute VTE during pregnancy, the delivery hospitalization, or ≤60 days postpartum who received at least one prescription postpartum for anticoagulants. Risks of (1) chronic PE and (2) post-thrombotic syndrome were evaluated for women at 6, 12, 24, and 60 months after delivery hospitalization through 2017 via the International Classification of Diseases, Ninth/Tenth Revision, Clinical Modification codes. Results Of 4,267 of 4,128,900 pregnancies complicated by VTE, the majority had DVT alone (61.8%, n = 2,637), while 25.8% had PE alone (n = 1,103) and 12.4% (n = 527) had both DVT and PE. Of the entire cohort, 3,328 retained insurance coverage at 6 months, 2,823 at 12 months, 2,161 at 24 months, and 831 at 60 months. Restricted to DVT, risk of post-thrombotic syndrome was 0.7% at 6 months (n = 17), 1.1% at 12 months (n = 22), 1.7% at 24 months (n = 26), and 2.7% at 60 months (n = 16). Among women with PE diagnoses, the risk of chronic PE was 2.4% at 6 months (n = 30), 3.3% at 12 months (n = 36), 4.2% at 24 months (n = 36), and 7.2% at 60 months (n = 24). Discussion In comparison to the general population, the risk of post-thrombotic syndrome was lower. In comparison, the risk of chronic PE was similar to the estimates in the general population at comparable time points after PE events. For women with obstetric PE, it may be appropriate to be vigilant for findings and symptoms associated with chronic PE. Key Points

scholarly journals Risk and predictors of heart failure in sarcoidosis in a population-based cohort study from Sweden

Heart ◽  
2021 ◽  
pp. heartjnl-2021-319129
Author(s):  
Marios Rossides ◽  
Susanna Kullberg ◽  
Johan Grunewald ◽  
Anders Eklund ◽  
Daniela Di Giuseppe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
General Population ◽  
Strong Predictor ◽  
Strong Association ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Clinical Predictors ◽  
Cox Models ◽  
Classification Of Diseases

ObjectivesPrevious studies showed a strong association between sarcoidosis and heart failure (HF) but did not consider risk stratification or risk factors to identify useful aetiological insights. We estimated overall and stratified HRs and identified risk factors for HF in sarcoidosis.MethodsSarcoidosis cases were identified from the Swedish National Patient Register (NPR; ≥2 International Classification of Diseases-coded visits, 2003–2013) and matched to general population comparators. They were followed for HF in the NPR. Treated were cases who were dispensed ≥1 immunosuppressant ±3 months from the first sarcoidosis visit (2006–2013). Using Cox models, we estimated HRs adjusted for demographics and comorbidity and identified independent risk factors of HF together with their attributable fractions (AFs).ResultsDuring follow-up, 204 of 8574 sarcoidosis cases and 721 of 84 192 comparators were diagnosed with HF (rate 2.2 vs 0.7/1000 person-years, respectively). The HR associated with sarcoidosis was 2.43 (95% CI 2.06 to 2.86) and did not vary by age, sex or treatment status. It was higher during the first 2 years after diagnosis (HR 3.7 vs 1.9) and in individuals without a history of ischaemic heart disease (IHD; HR 2.7 vs 1.7). Diabetes, atrial fibrillation and other arrhythmias were the strongest independent clinical predictors of HF (HR 2.5 each, 2-year AF 20%, 16% and 12%, respectively).ConclusionsAlthough low, the HF rate was more than twofold increased in sarcoidosis compared with the general population, particularly right after diagnosis. IHD history cannot solely explain these risks, whereas ventricular arrhythmias indicating cardiac sarcoidosis appear to be a strong predictor of HF in sarcoidosis.

Prevalence and incidence of doctor-diagnosed Dupuytren’s disease: a population-based study

2017 ◽  
Vol 42 (7) ◽  
pp. 673-677 ◽  
Author(s):  
J. Nordenskjöld ◽  
M. Englund ◽  
C. Zhou ◽  
I. Atroshi
Keyword(s):  
General Population ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Dupuytren’S Disease ◽  
Level Of Evidence ◽  
Dupuytren's Disease ◽  
Population Based Study ◽  
Classification Of Diseases ◽  
First Time

The prevalence and incidence of doctor-diagnosed Dupuytren’s disease in the general population is unknown. From the healthcare register for Skåne region (population 1.3 million) in southern Sweden, we identified all residents aged ⩾20 years (on 31 December 2013), who 1998 to 2013 had consulted a doctor and received the diagnosis Dupuytren’s disease (International Classification of Diseases 10th Revision code M720). During the 16 years, 7207 current residents (72% men) had been diagnosed with Dupuytren’s disease; the prevalence among men was 1.35% and among women 0.5%. Of all people diagnosed, 56% had received treatment (87% fasciectomy). In 2013, the incidence of first-time doctor-diagnosed Dupuytren’s disease among men was 14 and among women five per 10,000. The annual incidence among men aged ⩾50 years was 27 per 10,000. Clinically important Dupuytren’s disease is common in the general population. Level of evidence: III

scholarly journals Links Between Strokes and Hereditary Hemorrhagic Telangiectasia: A Population-Based Study

2018 ◽  
Vol 46 (1) ◽  
pp. 44-50
Author(s):  
Farah N. Chowdhury ◽  
G. Sanjaya Chandrarathne ◽  
Kristopher D. Masilamani ◽  
Jennifer T. N. LaBranche ◽  
Shaun Malo ◽  
...  
Keyword(s):  
General Population ◽  
Hereditary Hemorrhagic Telangiectasia ◽  
Female Gender ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Stroke Subtype ◽  
Stroke Incidence ◽  
Centre Of Excellence ◽  
Classification Of Diseases ◽  
Icd 10

AbstractBackgroundHereditary hemorrhagic telangiectasia (HHT) is a disease of abnormal vasculature where patients are predisposed to strokes of multiple etiologies. We assessed yearly stroke incidence among Albertans with HHT and compared with the general population. Given the tendency for stroke in HHT patients, we expected HHT patients to have higher stroke incidence, in particular at younger ages.MethodsPopulation-based administrative health data on inpatient and ambulatory admissions were extracted over a 16-year period using International Classification of Diseases (ICD)-9 and ICD-10, Canada codes. We analyzed overall occurrence of strokes in Alberta by age, gender, stroke subtype, and diagnosis of HHT.ResultsThe age-standardized incidence rate of stroke in HHT was 450 per 100,000 compared with 260 per 100,000 in the general population with a rate ratio of 1.73 (95% confidence interval (CI) [1.046-2.842]). This study found a higher HHT prevalence in Alberta (1 in 3800) compared to the world average of 1 in 5000. Women were also more likely to be diagnosed with HHT, with a 3.25:1 female gender preponderance in the yearly incidence.InterpretationThis study not only shows that HHT patients are at higher risk of having a stroke but also quantifies that risk using an age-adjusted metric in Alberta. This province has a higher than expected disease burden of HHT, with the majority of cases affecting women. Our study found that acute ischemic strokes and transient ischemic attacks are far more common than hemorrhage in HHT. As HHT is a rare, multi-system, chronic disease, these patients should be referred to an HHT Centre of Excellence.

scholarly journals Utility of Methicillin-Resistant Staphylococcus aureus Nares Screening for Patients with a Diabetic Foot Infection

2020 ◽  
Vol 64 (4) ◽  
Author(s):  
Kari A. Mergenhagen ◽  
Michael Croix ◽  
Kaitlyn E. Starr ◽  
John A. Sellick ◽  
Alan J. Lesse
Keyword(s):  
Staphylococcus Aureus ◽  
Diabetic Foot ◽  
International Classification Of Diseases ◽  
Methicillin Resistant ◽  
Content Type ◽  
Diabetic Foot Infection ◽  
Entire Cohort ◽  
Diabetic Foot Infections ◽  
Medical Centers ◽  
Classification Of Diseases

ABSTRACT Treatment of suspected methicillin-resistant Staphylococcus aureus (MRSA) is a cornerstone of severe diabetic foot infections; however, antibiotics can be associated with toxicity. The objective of this study was to determine the negative predictive value (NPV) of MRSA nares screening in the determination of subsequent MRSA in patients with a diabetic foot infection. This was a retrospective cohort study across Veterans Affairs (VA) medical centers from 1 January 2007 to 1 January 2018. Data from patients with an International Classification of Diseases (ICD) code for a diabetic foot infection with MRSA nares screening, and subsequent cultures were evaluated for the presence of MRSA. NPVs were calculated for the entire cohort, as well as for a subgroup representing deep cultures. Additionally, the distribution of all pathogens isolated from diabetic foot infections was determined. A total of 8,163 episodes were included in the analysis for NPV. The NPV of MRSA nares screening for MRSA diabetic foot infection was 89.6%. For the deep cultures, the NPV was 89.2%. The NPV for cultures originating from the foot was 89.7%, and the NPV for those originating from the toe was 89.4%. There were 17,822 pathogens isolated from the diabetic foot cultures. MRSA was isolated in 7.5% of cultures, and methicillin-susceptible S. aureus was isolated in 24.8%. Enterococcus was identified in 14.7% of cultures, Proteus in 7.3%, and Pseudomonas in 6.8% of cultures. Given the high NPVs, the use of MRSA nares screening may be appropriate as a stewardship tool for deescalation and avoidance of empirical anti-MRSA therapy in patients who are not nasal carries of MRSA.

Anatomically Associated Venous Thromboembolism in Patients With Peripherally Inserted Central Catheters

2017 ◽  
Vol 22 (4) ◽  
pp. 182-187
Author(s):  
Travis Kimple ◽  
Niaman Nazir ◽  
Chad M. Cannon
Keyword(s):  
Venous Thromboembolism ◽  
International Classification Of Diseases ◽  
Tertiary Hospital ◽  
Peripherally Inserted Central Catheters ◽  
Vein Thrombosis ◽  
Icd9 Code ◽  
Classification Of Diseases ◽  
Clinically Significant ◽  
Deep Vein ◽  
Central Catheters

Abstract Background: Peripherally inserted central catheters (PICCs) are ubiquitous in modern hospitals, but are associated with venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and/or pulmonary embolism (PE). We retrospectively examined this association in hospitalized patients, highlighting anatomically associated VTEs (those with DVT in the PICC extremity). Methods: Charts with an International Classification of Diseases, Ninth Revision (ICD9) code for VTE were collected from a discharge database of PICC-managed patients at a tertiary hospital. A sample (52.3%) of the VTE charts was manually reviewed to verify PICC-associated VTE (unverified charts were excluded), and determine such data as the extremity in which each DVT was diagnosed (using ultrasound reports). VTE rates were calculated using an uncorrected method (from charts with VTE ICD9 code) and a corrected method (from charts with manually verified PICC-associated VTE). Results: Our uncorrected VTE rate was 3.9% (P < .0001), whereas the corrected rate was 1.5%. Among 125 charts with manually verified PICC-associated VTE, 69 (60.5%) out of 114 patients with a DVT had their DVT occur in the PICC extremity, yielding an anatomically associated VTE rate of 0.84%. The most common reason for a chart being excluded (60.2%) was a VTE occurring before PICC placement. Conclusions: We found clinically significant rates of PICC-associated VTE. The majority of patients' DVT occurred in the same extremity as their PICC, lending further evidence that PICCs are an independent risk factor for VTE and require judicious use. There was also a discrepancy in VTE rate derived from ICD codes alone vs. manual chart review.

Adjustment Disorder: Empirical Study of a New Diagnostic Concept for Icd-11 in the General Population in Lithuania

2016 ◽  
Vol 40 ◽  
pp. 20-25 ◽  
Author(s):  
P. Zelviene ◽  
E. Kazlauskas ◽  
J. Eimontas ◽  
A. Maercker
Keyword(s):  
Factor Analysis ◽  
General Population ◽  
Factor Model ◽  
Structural Models ◽  
Adjustment Disorder ◽  
International Classification Of Diseases ◽  
Confirmatory Factor ◽  
Classification Of Diseases ◽  
Core Symptoms

AbstractObjectiveAdjustment disorder (AD) is one of the most debated diagnoses in psychiatry since it has been recognised as vaguely defined and causing a lot of difficulties in clinical practice. We aimed to analyse the structure of adjustment disorder based on International Classification of Diseases (ICD)–11 proposals by the WHO ICD-11 Working Group on the Classification of Disorders Specifically Associated with Stress in the general population in Lithuania. Three structural models of adjustment disorder were tested using Confirmatory Factor Analysis (CFA).MethodData from the sample of 649 participants who experienced at least one significant stressor during the last two years was included in CFA analysis. Stressor exposure and AD symptoms were measured with the Lithuanian version of the Adjustment Disorder New Module (ADNM-20).ResultsThe CFA analysis revealed that the two core factor model of the AD with two core symptoms: preoccupation and failure to adapt fitted data the best in contrast to other two models.ConclusionThe study supports the ICD-11 proposal for the structure of adjustment disorder with two core symptoms: preoccupation and failure to adapt. Further studies are needed to analyse the structure of AD in other populations.

Clinical characteristics and outcomes of patients with venous thromboembolism according to diagnosis on weekends versus weekdays: from the COMMAND VTE Registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y Yamashita ◽  
T Morimoto ◽  
T Makiyama ◽  
K Ono ◽  
T Kimura
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
Clinical Outcomes ◽  
Clinical Characteristics ◽  
Anticoagulation Therapy ◽  
Treatment Strategies ◽  
Funding Source ◽  
Medical Systems ◽  
Severe Condition ◽  
Entire Cohort

Abstract Background/Introduction The medical systems of hospitals often differs between on weekends and weekdays. These differences could lead different clinical outcomes for patients with acute medical conditions that require complex treatment strategies. However, the effect of the time of diagnosis on clinical outcomes in patients with acute venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis (DVT), is still controversial. Purpose We sought to evaluate the clinical characteristics and outcomes of patients with VTE comparing on weekends and weekdays in a large observational database of VTE in Japan. Methods The COMMAND VTE Registry is a multicenter registry enrolling 3027 consecutive patients with acute symptomatic VTE objectively confirmed by imaging examination or by autopsy among 29 centers in Japan between January 2010 and August 2014. In the current analysis, diagnosis on weekends was defined as diagnosis during the period from 00:00 hours on Saturday to 24:00 on Sunday. All other times were defined as weekdays. We divided the entire cohort into 2 groups; diagnosis on weekends and diagnosis on weekdays groups, and we compared the clinical characteristics, management strategies and 30-day outcomes between the 2 groups. Results The current study population consisted of 337 patients diagnosed on weekends and 2690 patients diagnosed on weekdays. The median days from onset to diagnosis were shorter in the patients diagnosed on weekends than in those diagnosed on weekdays (2 days vs. 4 days, P<0.001). The patients diagnosed on weekends presented with PE more frequently (72% vs. 55%, P<0.001), and they showed more severe condition for PE with a higher simplified pulmonary embolism severity index score. The vast majority of PE patients were diagnosed by contrast-enhanced computed tomography in both groups (97% vs. 97%, P=0.67). The patients diagnosed on weekends more often received initial parenteral anticoagulation therapy and thrombolysis than those diagnosed on weekdays. The cumulative 30-day incidence of all-cause death was not significantly different between the 2 groups among PE patients (diagnosis on weekends: 6.2% vs. diagnosis on weekdays: 6.5%, P=0.87), as well as among DVT patients (0.0% vs. 1.5%, P=0.24) (Figure). After adjusting the confounders, the risk of diagnosis on weekends relative to diagnosis on weekdays for all-cause death among PE patients was still insignificant (adjusted HR: 0.76; 95% CI: 0.42–1.28). The most frequent cause of deaths was fatal PE in both groups among PE patients. The risks for recurrent VTE and major bleeding at 30 days were not significantly different between the 2 groups among PE patients nor DVT patients. Conclusions The VTE patients diagnosed on weekends presented with PE more frequently, and they showed more severe condition for PE, although the risks for short-term mortality were not significantly different between patients diagnosed on weekends and weekdays. Kaplan-Meier curves for all-cause death Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Research Institute for Production Development, Mitsubishi Tanabe Pharma Corporation

Fetal Echocardiogram and Detailed First Trimester Obstetric Ultrasound: ICD-10 Indications

2021 ◽  
Author(s):  
Fadi Bsat ◽  
Barbra M. Fisher ◽  
Trisha Malisch ◽  
Vanita Jain
Keyword(s):  
First Trimester ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Obstetric Ultrasound ◽  
American Institute ◽  
Key Points ◽  
National Organizations ◽  
Classification Of Diseases ◽  
Icd 10

The American Institute of Ultrasound in Medicine and multiple national organizations have published the indications for fetal echocardiogram and for the detailed first trimester obstetric ultrasound. We present the corresponding International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes for those indications. Key Points

Frotteuristic Disorder

2019 ◽  
pp. 97-108
Author(s):  
J. Paul Fedoroff
Keyword(s):  
Differential Diagnosis ◽  
General Population ◽  
Mental Disorders ◽  
International Classification Of Diseases ◽  
Adult Males ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Sexual Stimulation ◽  
Classification Of Diseases

Abstract: Frotteuristic disorder is a condition defined as recurrent and intense sexual arousal from touching or rubbing against a nonconsenting person, as manifested by fantasies, urges, or behaviors, or by rubbing against non-consenting people for sexual stimulation. It has been reported that up to 30% of adult males in the general population may have committed frotteuristic acts. This chapter reviews the Fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and the International Classification of Diseases criteria for frotteurism. Conditions for consideration in the differential diagnosis are discussed. Treatment and prognosis are discussed, and the recent literature on these topics is reviewed.

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