Search

Ondine Walter,1,2 Julien Maquet,1,2 Helene Derumeaux,3 Guillaume Moulis,1,2 Margaux Lafaurie2,4 1Service de Médecine Interne, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; 2Centre d’Investigation Clinique 1436, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; 3Département d’Information Médicale, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; 4Service de Pharmacologie Médicale et Clinique, Faculté de Médecine, Centre Hospitalier Universitaire de Toulouse, Toulouse, FranceCorrespondence: Ondine WalterService de Médecine Interne, pavillon URM, CHU Purpan, place du Dr Baylac, TSA 40031, 31059, Toulouse Cedex 9, FranceTel +33 561 779 677Fax +33 561 778 058Email walter.o@chu-toulouse.frKeywords: sickle cell anemia, vaso occlusive crisis, predictive value of test, epidemiology

Sébastien De Almeida Chaves,1 Hélène Derumeaux,2 Phuong Do Minh,1 Maryse Lapeyre-Mestre,3– 5 Guillaume Moulis,1,4,5 Grégory Pugnet1,4,5 1Department of Internal Medicine, CHU Toulouse, Toulouse, France; 2Department of Medical Information, CHU Toulouse, Toulouse, France; 3Department of Medical and Clinical Pharmacology, CHU Toulouse, Toulouse, France; 4UMR 1027 Inserm-University of Toulouse, Toulouse, France; 5Clinical Investigation Center 1436, CHU Toulouse, Toulouse, FranceCorrespondence: Grégory PugnetService de Médecine Interne, CHU Toulouse Purpan, 1 Place du Dr Joseph Baylac, TSA 40031, 31059, Toulouse Cedex 9, FranceTel +33 5 61 77 71 26Fax +33 5 61 77 71 24Email pugnet.g@chu-toulouse.frImportance: With the increased use of data from electronic medical records for research, it is important to validate in-patient electronic health records/hospital electronic health records for specific diseases identification using International Classification of Diseases, Tenth Revision (ICD-10) codes.Objective: To assess the accuracy of using ICD-10 codes to identify systemic sclerosis (SSc) in the French hospital database.Design, Setting, and Participants: Electronic health record database analysis. The setting of the study’s in-patient database was the Toulouse University Hospital, a tertiary referral center (2880 beds) that serves approximately 2.9 million inhabitants. Participants were patients with ICD-10 discharge diagnosis codes of SSc seen at Toulouse University Hospital between January 1, 2010, and December 31, 2017.Main Outcomes and Measures: The main outcome was the positive predictive value (PPV) of discharge diagnosis codes for identifying SSc. The PPVs were calculated by determining the ratio of the confirmed cases found by medical record review to the total number of cases identified by ICD-10 code.Results: Of the 2766 hospital stays, 216 patients were identified by an SSc discharge diagnosis code. Two hundred were confirmed as SSc after medical record review. The overall PPV was 93% (95% CI, 88– 95%). The PPV for limited cutaneous SSc was 95% (95% CI, 85– 98%).Conclusions and Relevance: Our results suggest that using ICD-10 codes alone to capture SSc is reliable in The French hospital database.Keywords: systemic sclerosis, International Classification of Diseases, positive predictive value, sensitivity, hospital database

Guillaume Moulis, Christian Fynbo Christiansen, Bianka Darvalics, Ina Trolle Andersen, Mette Nørgaard Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, DenmarkCorrespondence: Guillaume MoulisDepartment of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Olof Palmes Allé 43-45, Aarhus N 8200, DenmarkTel +45 871 68205Fax +45 871 67215Email gmoulis@hotmail.comBackground: Apart from their hemostatic role, platelets are immune cells that play a role in fighting infections. The presence of thrombocytopenia and thrombocytosis at hospital admission are predictors of mortality in community-acquired pneumonia patients. We hypothesized that variations in platelet counts within the normal range also may be associated with mortality in these patients.Methods: The study included all adults in the North and Central Denmark Regions with a first acute hospital admission for community-acquired pneumonia during 2006– 2012. We assessed the association between the first platelet count within ± 24 hours of admission (within the normal range of 150 to 400 x 109/L) and 30-day mortality using Cox models. Analyses were adjusted for age, sex, Charlson Comorbidity Index score, hemoglobin level, leukocyte count, and creatinine level at admission.Results: Among the 12,905 study patients, 30-day mortality was 12.4%. The mean platelet count upon admission was 250 × 109/L. Compared with the 250– 275 × 109/L category, platelet counts of 151– 175 were associated with a lower 30-day mortality (adjusted hazard ratio [aHR]: 0.79, 95% confidence interval [CI]: 0.63– 0.99), while higher platelet counts were associated with a higher 30-day mortality (351– 375 × 109/L, aHR: 1.34, 95% CI: 1.07– 1.68; 376– 400× 109/L, aHR: 1.21, 95% CI: 0.94– 1.56).Conclusion: Platelet counts, even within the normal range, are associated with mortality in adult patients hospitalized for community-acquired pneumonia.Keywords: platelet count, thrombocytopenia, thrombocytosis, community-acquired pneumonia, mortality

Guillaume Moulis,1–3,* Berta Ibañez,4–6,* Aurore Palmaro,2,3 Felipe Aizpuru,6–8 Eduardo Millan,6,8 Maryse Lapeyre-Mestre,2,3,9 Laurent Sailler,1–3 Koldo Cambra5,6,10 1Department of Internal Medicine, Toulouse University Hospital, Toulouse, France; 2UMR1027 INSERM, University of Toulouse, Toulouse, France; 3Clinical Investigation Center 1436, Toulouse University Hospital, Toulouse, France; 4Navarrabiomed, Health Department, Public University of Navarra, Pamplona, Spain; 5IdiSNA, Pamplona, Spain; 6Health Service Research on Chronic Patients Network (REDISSEC), Pamplona, Spain; 7Research Unit Araba (BioAraba), Osakidetza-Basque Health Department, Vitoria-Gasteiz, Spain; 8Healthcare Services Sub-directorate, Osakidetza-Basque Health Service, Araba, Spain; 9Department of Medical and Clinical Pharmacology, Toulouse University Hospital, Toulouse, France; 10Institute of Public Health and Labour Health of Navarra, Pamplona, Spain *These authors contributed equally to this work Aim: The EPICHRONIC (EPIdemiology of CHRONIC diseases) project investigated the possibility of developing common procedures for French and Spanish electronic health care databases to enable large-scale pharmacoepidemiological studies on chronic diseases. A feasibility study assessed the prevalence of type 2 diabetes mellitus (T2DM) in Navarre and the Basque Country (Spain) and the Midi-Pyrénées region (France). Patients and methods: We described and compared database structures and the availability of hospital, outpatient, and drug-dispensing data from 5.9 million inhabitants. Due to differences in database structures and recorded data, we could not develop a common procedure to estimate T2DM prevalence, but identified an algorithm specific to each database. Patients were identified using primary care diagnosis codes previously validated in Spanish databases and a combination of primary care diagnosis codes, hospital diagnosis codes, and data on exposure to oral antidiabetic drugs from the French database. Results: Spanish and French databases (the latter termed Système National d’Information Inter-Régimes de l’Assurance Maladie [SNIIRAM]) included demographic, primary care diagnoses, hospital diagnoses, and outpatient drug-dispensing data. Diagnoses were encoded using the International Classification of Primary Care (version 2) and the International Classification of Diseases, version 9 and version 10 (ICD-9 and ICD-10) in the Spanish databases, whereas the SNIIRAM contained ICD-10 codes. All data were anonymized before transferring to researchers. T2DM prevalence in the population over 20 years was estimated to be 6.6–7.0% in the Spanish regions and 6.3% in the Midi-Pyrénées region with ~2% higher estimates for males in the three regions. Conclusion: Tailored procedures can be designed to estimate the prevalence of T2DM in population-based studies from Spanish and French electronic health care records. Keywords: epidemiology, pharmacoepidemiology, electronic health care database, cross-national study, population-based study, type 2 diabetes mellitus