Abstract P152: Impact Of New Hypertension Guidelines On The Prevalence And Control Of Hypertension In A Clinical Hiv Cohort

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Vishnu Priya Mallipeddi ◽  
Matthew Levy ◽  
Anne Monroe ◽  
Letumile Moeng ◽  
Lindsey Powers Happ ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
International Classification Of Diseases ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Diagnosis Codes ◽  
Classification Of Diseases ◽  
New Guidelines ◽  
Living With Hiv ◽  
And Control

Introduction: People living with HIV (PLWH) with hypertension (HTN) have a higher risk of cardiovascular events and all-cause mortality compared with PLWH with normal blood pressure (BP) and HIV-uninfected adults with HTN. The prevalence and control of HTN among PLWH have not been widely studied since the release of newer 2017 ACC/AHA guidelines (new guidelines). To address this research gap, we evaluated and compared the prevalence and control of HTN using both 2003 JNC 7 (old guidelines) and new guidelines in a large clinical cohort of PLWH. Methods: We identified 3206 PLWH with HTN from the DC Cohort study in Washington, D.C, from 01/2018 to 06/2019. We defined HTN using International Classification of Diseases (ICD) -9/-10 diagnosis codes for HTN or ≥ 2 BP measurements obtained at least one month apart (>139/89 mm Hg per old or >129/79 mm Hg per new guidelines). We defined HTN control based on recent BP (≤139/≤89 mm Hg per old or ≤129/≤79 mm Hg per new guidelines). We identified socio-demographics, cardiovascular risk factors and co-morbidities associated with HTN control (per new guidelines) using multivariable logistic regression (adjusted Odds Ratio; 95% CI). Results: The prevalence of HTN was 50.9% per old versus 62.2% per new guidelines. Of the 3,206 PLWH with HTN based on 2017 ACC/AHA guidelines, 887 (27.7%) had a recent BP ≤129/≤79 mm Hg, 1,196 (37.3%) had a BP between 130-139/80-89 mm Hg and 1,123 (35.0%) had a BP ≥140/≥90mm Hg. After adjusting for socio-demographics, cardiovascular risk factor and co-morbidities, factors associated with HTN control included age 60-69 (vs. <40) years (1.42; 1.03-1.98), Hispanic (vs. non-Hispanic Black) race/ethnicity (1.49;1.04-2.15), receipt of HIV care at a hospital-based (vs. community-based) clinic (1.21; 1.00-1.47), being unemployed (1.42; 1.11-1.83), and diabetes (1.35; 1.13-1.63). Conclusion: In a large urban cohort of PLWH, nearly two-thirds had HTN and less than one-third of those met new guideline criteria. Older PLWH were more likely to have their HTN controlled compared to the younger PLWH. Our data suggests that more aggressive HTN control is warranted among PLWH, with attention to younger patients.

scholarly journals Association Between Diagnosis Code Expansion and Changes in 30‐Day Risk‐Adjusted Outcomes for Cardiovascular Diseases

2021 ◽  
Author(s):  
Lauren Gilstrap ◽  
Rishi K. Wadhera ◽  
Andrea M. Austin ◽  
Stephen Kearing ◽  
Karen E. Joynt Maddox ◽  
...  
Keyword(s):  
Logistic Regression ◽  
International Classification Of Diseases ◽  
Fee For Service ◽  
Readmission Rates ◽  
Difference In Differences ◽  
Diagnosis Codes ◽  
Classification Of Diseases ◽  
Changes In Risk ◽  
The Impact

BACKGROUND In January 2011, Centers for Medicare and Medicaid Services expanded the number of inpatient diagnosis codes from 9 to 25, which may influence comorbidity counts and risk‐adjusted outcome rates for studies spanning January 2011. This study examines the association between (1) limiting versus not limiting diagnosis codes after 2011, (2) using inpatient‐only versus inpatient and outpatient data, and (3) using logistic regression versus the Centers for Medicare and Medicaid Services risk‐standardized methodology and changes in risk‐adjusted outcomes. METHODS AND RESULTS Using 100% Medicare inpatient and outpatient files between January 2009 and December 2013, we created 2 cohorts of fee‐for‐service beneficiaries aged ≥65 years. The acute myocardial infarction cohort and the heart failure cohort had 578 728 and 1 595 069 hospitalizations, respectively. We calculate comorbidities using (1) inpatient‐only limited diagnoses, (2) inpatient‐only unlimited diagnoses, (3) inpatient and outpatient limited diagnoses, and (4) inpatient and outpatient unlimited diagnoses. Across both cohorts, International Classification of Diseases, Ninth Revision ( ICD‐9 ) diagnoses and hierarchical condition categories increased after 2011. When outpatient data were included, there were no significant differences in risk‐adjusted readmission rates using logistic regression or the Centers for Medicare and Medicaid Services risk standardization. A difference‐in‐differences analysis of risk‐adjusted readmission trends before versus after 2011 found that no significant differences between limited and unlimited models for either cohort. CONCLUSIONS For studies that span 2011, researchers should consider limiting the number of inpatient diagnosis codes to 9 and/or including outpatient data to minimize the impact of the code expansion on comorbidity counts. However, the 2011 code expansion does not appear to significantly affect risk‐adjusted readmission rate estimates using either logistic or risk‐standardization models or when using or excluding outpatient data.

scholarly journals Use of Diagnosis Codes and/or Wound Culture Results for Surveillance of Surgical Site Infection after Mastectomy and Breast Reconstruction

2010 ◽  
Vol 31 (05) ◽  
pp. 544-547 ◽  
Author(s):  
Margaret A. Olsen ◽  
Victoria J. Fraser
Keyword(s):  
Surgical Site Infection ◽  
Claims Data ◽  
Breast Surgery ◽  
International Classification Of Diseases ◽  
Site Infection ◽  
Wound Culture ◽  
Diagnosis Codes ◽  
Classification Of Diseases ◽  
Major Breast

We compared surveillance of surgical site infection (SSI) after major breast surgery by using a combination of International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes and microbiology-based surveillance. The sensitivity of the coding algorithm for identification of SSI was 87.5%, and the sensitivity of wound culture for identification of SSI was 78.1%. Our results suggest that SSI surveillance can be reliably performed using claims data.

The prevalence of localised scleroderma in childhood assessed in the administrative claims data from the United States

2018 ◽  
Vol 4 (1) ◽  
pp. 77-78
Author(s):  
Timothy Beukelman ◽  
Fenglong Xie ◽  
Ivan Foeldvari
Keyword(s):  
United States ◽  
Systemic Sclerosis ◽  
Claims Data ◽  
International Classification Of Diseases ◽  
The United States ◽  
Administrative Claims ◽  
Administrative Claims Data ◽  
Diagnosis Codes ◽  
Classification Of Diseases

Juvenile localised scleroderma is believed an orphan autoimmune disease, which occurs 10 times more often than systemic sclerosis in childhood and is believed to have a prevalence of 1 per 100,000 children. To gain data regarding the prevalence of juvenile localised scleroderma, we assessed the administrative claims data in the United States using the International Classification of Diseases, Ninth Revision diagnosis codes. We found an estimated prevalence in each year ranging from 3.2 to 3.6 per 10,000 children. This estimate is significantly higher as found in previous studies.

scholarly journals Ventricular Ectopy and Arrhythmia Characteristics for Persons Living with HIV and Uninfected Controls

2019 ◽  
Vol 18 ◽  
pp. 232595821985212
Author(s):  
Alexander Meyer ◽  
Sanjay Dandamudi ◽  
Chad Achenbach ◽  
Donald Lloyd-Jones ◽  
Matthew Feinstein
Keyword(s):  
Cardiovascular Disease ◽  
Chart Review ◽  
International Classification Of Diseases ◽  
Elevated Risk ◽  
Ventricular Ectopy ◽  
Persons Living With Hiv ◽  
Significant Difference ◽  
Classification Of Diseases ◽  
Living With Hiv

Background: Persons with HIV have elevated risk for cardiovascular disease, but little is known about the risk of ventricular ectopy and ventricular tachycardia (VE/VT) for HIV-infected (HIV+) persons. Methods: We evaluated the presence and anatomic origin of VE/VT for HIV+ persons and controls by screening a cohort using International Classification of Diseases codes and adjudicating positive screens by chart review. We sought to evaluate (1) presence of VE/VT and (2) likely anatomic origin of the VE/VT based on electrocardiogram. Results: There was no significant difference in the prevalence of VE/VT for HIV+ or uninfected persons. Among HIV+ persons, worse HIV control was associated with significantly greater odds of VE/VT. Exploratory analyses suggested that HIV+ persons may have a greater likelihood of VE/VT originating from the left ventricle. Conclusion: Although worse HIV control was associated with higher odds of VE/VT among persons with HIV, odds of VE/VT were not higher for persons with HIV than uninfected persons.

Evaluation of International Classification of Diseases, Ninth Revision, Clinical Modification Codes for Reporting Methicillin-Resistant Staphylococcus aureus Infections at a Hospital in Illinois

2010 ◽  
Vol 31 (05) ◽  
pp. 463-468 ◽  
Author(s):  
Melissa K. Schaefer ◽  
Katherine Ellingson ◽  
Craig Conover ◽  
Alicia E. Genisca ◽  
Donna Currie ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Care Hospital ◽  
Methicillin Resistant ◽  
Diagnosis Codes ◽  
Classification Of Diseases ◽  
Mrsa Infection ◽  
Healthcare Associated

Background. States, including Illinois, have passed legislation mandating the use of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for reporting healthcare-associated infections, such as methicillin-resistant Staphylococcus aureus (MRSA). Objective. To evaluate the sensitivity of ICD-9-CM code combinations for detection of MRSA infection and to understand implications for reporting. Methods. We reviewed discharge and microbiology databases from July through August of 2005, 2006, and 2007 for ICD-9-CM codes or microbiology results suggesting MRSA infection at a tertiary care hospital near Chicago, Illinois. Medical records were reviewed to confirm MRSA infection. Time from admission to first positive MRSA culture result was evaluated to identify hospital-onset MRSA (HO-MRSA) infections. The sensitivity of MRSA code combinations for detecting confirmed MRSA infections was calculated using all codes present in the discharge record (up to 15); the effect of reviewing only 9 diagnosis codes, the number reported to the Centers for Medicare and Medicaid Services, was also evaluated. The sensitivity of the combination of diagnosis codes for detection of HO-MRSA infections was compared with that for community-onset MRSA (CO-MRSA) infections. Results. We identified 571 potential MRSA infections with the use of screening criteria; 403 (71%) were confirmed MRSA infections, of which 61 (15%) were classified as HO-MRSA. The sensitivity of MRSA code combinations was 59% for all confirmed MRSA infections when 15 diagnoses were reviewed compared with 31% if only 9 diagnoses were reviewed (P &lt; .001). The sensitivity of code combinations was 33% for HO-MRSA infections compared with 62% for CO-MRSA infections (P &lt; .001). Conclusions. Limiting analysis to 9 diagnosis codes resulted in low sensitivity. Furthermore, code combinations were better at revealing CO-MRSA infections than HO-MRSA infections. These limitations could compromise the validity of ICD-9-CM codes for interfacility comparisons and for reporting of healthcare-associated MRSA infections.

scholarly journals Validity of the International Classification of Diseases, 10th revision discharge diagnosis codes for hyponatraemia in the Danish National Registry of Patients

BMJ Open ◽  
2014 ◽  
Vol 4 (4) ◽  
pp. e004956 ◽  
Author(s):  
Louise Holland-Bill ◽  
Christian Fynbo Christiansen ◽  
Sinna Pilgaard Ulrichsen ◽  
Troels Ring ◽  
Jens Otto Lunde Jørgensen ◽  
...  
Keyword(s):  
International Classification Of Diseases ◽  
National Registry ◽  
International Classification ◽  
Discharge Diagnosis ◽  
Diagnosis Codes ◽  
Classification Of Diseases

Changes in the accuracy of administrative data for the detection of surgical site infections

2020 ◽  
pp. 1-3
Author(s):  
Brian T. Bucher ◽  
Meng Yang ◽  
Julie Arndorfer ◽  
Cherie Frame ◽  
Jan Orton ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Retrospective Analysis ◽  
Surgical Site Infections ◽  
International Classification Of Diseases ◽  
Site Infection ◽  
Diagnosis Codes ◽  
Infection Surveillance ◽  
Classification Of Diseases ◽  
Ninth Edition

Abstract We performed a retrospective analysis of the changes in accuracy of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis codes for colectomy and hysterectomy surgical site infection surveillance. After the transition from ICD-CM ninth edition to tenth edition codes, there was no significant change in the accuracy of these codes for SSI surveillance.

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