Vyas Vanessa, Fuccello Ashlynn, Corbin Seana L, Martin Bradley C, Schootman Mario, Mavros Michail N
Department of Surgery, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA.
Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA.
J Thromb Thrombolysis. 2025 Jun 22. doi: 10.1007/s11239-025-03125-y.
To examine whether the variability in ICD codes used for venous thromboembolism (VTE) definition among published studies affects VTE rates and associations detected from claims data. We extracted the ICD codes used for VTE definition from three published studies and proposed a new VTE definition based on clinical review of all utilized ICD codes. We compared these four definitions to assess differences in VTE rates and associated variables using a standardized scenario. We used a random 25% sample of the IQVIA PharMetrics® Plus for Academics database and analyzed patients undergoing gastrointestinal cancer surgery. The primary outcome was 90-day post-discharge VTE. The association of preoperative and intraoperative variables with VTE was assessed using bivariate and multivariable main effects logistic regression models. There were substantial differences in the use of ICD codes among the 4 VTE definitions (range 116 to 304 ICD-9/10 codes). Our population included 2,122 eligible patients (median age 59 years, 47% female) and the rate of VTE ranged from 2.3% to 4.4% using the four definitions. Multivariable analysis showed that the associations between VTE and age and type of surgery (esophageal surgery, gastric surgery) varied depending on the VTE definition used while the Elixhauser comorbidity score and liver surgery type were consistently associated with VTE. In this pilot study, differences in the incidence of VTE and associated risk factors were influenced by the choice of ICD9/10 codes used to define VTE. A standardized definition of VTE may improve the reproducibility and rigor of findings based on administrative claims data.
为了研究已发表研究中用于静脉血栓栓塞（VTE）定义的国际疾病分类（ICD）编码的变异性是否会影响从索赔数据中检测到的VTE发生率和关联。我们从三项已发表的研究中提取了用于VTE定义的ICD编码，并基于对所有使用的ICD编码的临床审查提出了一种新的VTE定义。我们比较了这四种定义，以使用标准化场景评估VTE发生率和相关变量的差异。我们使用了IQVIA PharMetrics® Plus for Academics数据库中25%的随机样本，并分析了接受胃肠道癌手术的患者。主要结局是出院后90天的VTE。使用双变量和多变量主效应逻辑回归模型评估术前和术中变量与VTE的关联。在4种VTE定义中，ICD编码的使用存在显著差异（ICD-9/10编码范围为116至304）。我们的研究人群包括2122名符合条件的患者（中位年龄59岁，47%为女性），使用这四种定义时VTE发生率在2.3%至4.4%之间。多变量分析表明VTE与年龄和手术类型（食管手术、胃手术）之间的关联因所使用的VTE定义而异，而埃利克斯豪泽合并症评分和肝脏手术类型与VTE始终相关。在这项初步研究中，VTE发生率和相关危险因素的差异受到用于定义VTE的ICD9/10编码选择的影响。VTE的标准化定义可能会提高基于行政索赔数据的研究结果的可重复性和严谨性。
