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Administrative Databases and Trends in In-Hospital Deaths in Pulmonary Embolism

Administrative Databases and Trends in In-Hospital Deaths in Pulmonary Embolism The recent article by Tsai et al1 highlights the trends in in-hospital deaths among hospitalizations with pulmonary embolism. Using the National Hospital Discharge Survey, they report a decreasing trend in case fatality rate between the years 2001 and 2008. Our group also recently investigated the outcomes of acute pulmonary embolism from the Nationwide Inpatient Sample, the largest all-payer inpatient care database in the United States, between the periods 2000 and 2008.2 Although we were looking at the differences in outcomes between weekend and weekday hospitalizations for patients admitted with a primary diagnosis of pulmonary embolism, we noted a significant trend in declining inpatient mortality. We used data from all patients coded with primary diagnosis of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes 415.11 and 415.19. These ICD-9-CM codes have been validated before, with a positive predictive value of 95%.3 We think that the similar results from these 2 reports from different large databases reflect the importance of using administrative databases to examine trends in outcomes for common medical conditions.4,5 They represent timely, “real-world” analyses of questions that may be too difficult to address using prospective randomized methods or extensive retrospective medical chart reviews. Use of large databases provides an important analytical resource as we embark on improving national health care efficacy in the current challenging environment. Back to top Article Information Correspondence: Dr Deshmukh, Department of Cardiovascular Medicine, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR 72205 (AJDeshmukh@uams.edu). Conflict of Interest Disclosures: None reported. References 1. Tsai J, Grosse SD, Grant AM, Hooper WC, Atrash HK. Trends in in-hospital deaths among hospitalizations with pulmonary embolism. Arch Intern Med. 2012;172(12):960-96122473671PubMedGoogle Scholar 2. Nanchal R, Kumar G, Taneja A, et al. Pulmonary embolism: the weekend effect [published online March 29, 2012]. Chest. 2012;142(3):690-69622459777PubMedGoogle ScholarCrossref 3. White RH, Garcia M, Sadeghi B, et al. Evaluation of the predictive value of ICD-9-CM coded administrative data for venous thromboembolism in the United States. Thromb Res. 2010;126(1):61-6720430419PubMedGoogle ScholarCrossref 4. Kumar G, Kumar N, Taneja A, et al; Milwaukee Initiative in Critical Care Outcomes Research Group of Investigators. Nationwide trends of severe sepsis in the 21st century (2000-2007). Chest. 2011;140(5):1223-123121852297PubMedGoogle ScholarCrossref 5. Deshmukh A, Kumar G, Kumar N, et al. Effect of Joint National Committee VII report on hospitalizations for hypertensive emergencies in the United States. Am J Cardiol. 2011;108(9):1277-128221890093PubMedGoogle ScholarCrossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Administrative Databases and Trends in In-Hospital Deaths in Pulmonary Embolism

Archives of Internal Medicine , Volume 172 (21) – Nov 26, 2012

Administrative Databases and Trends in In-Hospital Deaths in Pulmonary Embolism

Abstract

The recent article by Tsai et al1 highlights the trends in in-hospital deaths among hospitalizations with pulmonary embolism. Using the National Hospital Discharge Survey, they report a decreasing trend in case fatality rate between the years 2001 and 2008. Our group also recently investigated the outcomes of acute pulmonary embolism from the Nationwide Inpatient Sample, the largest all-payer inpatient care database in the United States, between the periods 2000 and 2008.2 Although we were...
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Publisher
American Medical Association
Copyright
Copyright © 2012 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/2013.jamainternmed.43
Publisher site
See Article on Publisher Site

Abstract

The recent article by Tsai et al1 highlights the trends in in-hospital deaths among hospitalizations with pulmonary embolism. Using the National Hospital Discharge Survey, they report a decreasing trend in case fatality rate between the years 2001 and 2008. Our group also recently investigated the outcomes of acute pulmonary embolism from the Nationwide Inpatient Sample, the largest all-payer inpatient care database in the United States, between the periods 2000 and 2008.2 Although we were looking at the differences in outcomes between weekend and weekday hospitalizations for patients admitted with a primary diagnosis of pulmonary embolism, we noted a significant trend in declining inpatient mortality. We used data from all patients coded with primary diagnosis of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes 415.11 and 415.19. These ICD-9-CM codes have been validated before, with a positive predictive value of 95%.3 We think that the similar results from these 2 reports from different large databases reflect the importance of using administrative databases to examine trends in outcomes for common medical conditions.4,5 They represent timely, “real-world” analyses of questions that may be too difficult to address using prospective randomized methods or extensive retrospective medical chart reviews. Use of large databases provides an important analytical resource as we embark on improving national health care efficacy in the current challenging environment. Back to top Article Information Correspondence: Dr Deshmukh, Department of Cardiovascular Medicine, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR 72205 (AJDeshmukh@uams.edu). Conflict of Interest Disclosures: None reported. References 1. Tsai J, Grosse SD, Grant AM, Hooper WC, Atrash HK. Trends in in-hospital deaths among hospitalizations with pulmonary embolism. Arch Intern Med. 2012;172(12):960-96122473671PubMedGoogle Scholar 2. Nanchal R, Kumar G, Taneja A, et al. Pulmonary embolism: the weekend effect [published online March 29, 2012]. Chest. 2012;142(3):690-69622459777PubMedGoogle ScholarCrossref 3. White RH, Garcia M, Sadeghi B, et al. Evaluation of the predictive value of ICD-9-CM coded administrative data for venous thromboembolism in the United States. Thromb Res. 2010;126(1):61-6720430419PubMedGoogle ScholarCrossref 4. Kumar G, Kumar N, Taneja A, et al; Milwaukee Initiative in Critical Care Outcomes Research Group of Investigators. Nationwide trends of severe sepsis in the 21st century (2000-2007). Chest. 2011;140(5):1223-123121852297PubMedGoogle ScholarCrossref 5. Deshmukh A, Kumar G, Kumar N, et al. Effect of Joint National Committee VII report on hospitalizations for hypertensive emergencies in the United States. Am J Cardiol. 2011;108(9):1277-128221890093PubMedGoogle ScholarCrossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Nov 26, 2012

Keywords: pulmonary embolism,hospital mortality

References