Aortic Dissections in the Population-Based Danish National Patient Registry from 1996-2016: A Validation Study

Lasse Mollegaard Obel; Jes S Lindholt; Anne N Lasota; Henrik K Jensen; Leila Louise Benhassen; Amalie L Kristensen; Reshaabi Srinanthalogen; Malina Christiansen; Henning Bundgaard; Mads Liisberg

doi:10.2147/CLEP.S341806

Aortic Dissections in the Population-Based Danish National Patient Registry from 1996-2016: A Validation Study

Clin Epidemiol. 2022 Jan 18:14:51-58. doi: 10.2147/CLEP.S341806. eCollection 2022.

Authors

Lasse Mollegaard Obel^{1

2}, Jes S Lindholt^{1

2}, Anne N Lasota³, Henrik K Jensen^{4

5}, Leila Louise Benhassen^{5

6}, Amalie L Kristensen^{5

6}, Reshaabi Srinanthalogen⁶, Malina Christiansen⁷, Henning Bundgaard⁷, Mads Liisberg^{1

2}

Affiliations

¹ Department of Cardiothoracic and Vascular Surgery, University Hospital Odense, Odense, Denmark.
² Elitary Research Centre of Individualized Medicine in Arterial Disease (CIMA), University Hospital Odense, Odense, Denmark.
³ Department of Vascular Surgery, Aalborg University Hospital, Aalborg, Denmark.
⁴ Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
⁵ Department of Clinical Medicine, Aarhus University, Health, Aarhus, Denmark.
⁶ Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark.
⁷ Department of Cardiology, The Heart Center, University of Copenhagen, Copenhagen, Denmark.

Abstract

Purpose: This study evaluated the validity of the ICD-10 diagnostic codes for aortic dissections (ADs) in the Danish National Patient Registry (DNPR) based upon positive predictive values (PPV).

Patients and methods: Cases registered in the DNPR with the unspecific AD diagnostic code DI710 (unspecified AD) from 1996 to 2016, and the specific AD diagnostic codes DI710A (AD Type A) and DI710B (AD Type B) from 2006 to 2016, were included. Available medical records from all registered cases underwent review. Confirmed cases of AD served as "gold standard" when reporting PPV. PPV estimates were stratified by regional differences, date, age at time of diagnosis, and sex.

Results: A total of 5018 cases were identified in the DNPR. After merging of data and retrieval of medical records, 3767 cases were eligible for validation. Of these, 2677 cases were verified as AD type A (59.7%), AD type B (38.8%), and unspecified type of AD (1.5%). The average age at diagnosis was 65.1 ±13.0 years (67.3% males). The overall PPV for having an AD when one of the three diagnostic codes were registered from 1996 to 2016 was 71.1% (95% confidence interval (CI): 69.6-72.5) and increased significantly over time. From 2006 to 2016, the PPV for the specific AD diagnostic codes was 89.5% (95% CI: 87.4-91.3), whilst the PPV for the unspecific diagnostic code was 63.5% (95% CI: 61.1-65.9).

Conclusion: We found the overall PPV for the pooled AD diagnostic codes in the DNPR acceptable. However, the two specific AD diagnostic codes presented remarkably higher PPV compared to the unspecific diagnostic code.

Keywords: aortic dissection; epidemiology; population-based; positive predicted values; validation.

Grants and funding

This study was supported by the University of Southern Denmark, the Helse foundation, and the Region of Southern Denmark.