Journal Article

A review of medical records and discharge summary data found moderate to high predictive values of discharge diagnoses of venous thromboembolism during pregnancy and postpartum

Larsen, Helle, Møller, Charlotte Ihlo, Johnsen, Søren Paaske, Larsen, Torben Bjerregaard, Sørensen, Henrik Toft

2005

Overview

To validate the discharge diagnoses of venous thromboembolism during pregnancy and postpartum, we examined the positive predictive value (PPV) of venous thromboembolic (VTE) discharge diagnoses associated with pregnancy or puerperium based on 311 cases registered in a Danish population-based hospital-discharge registry. Medical records and hospital discharge summaries were retrieved and reviewed using a standardized form. Standard and pregnancy-specific codes were used for 147 (49%) and 153 (51%) cases, respectively. The overall PPV of the selected codes was 87.3% (95% confidence interval [CI]: 83.0–90.9). When focusing on confirmed VTE events in relation to the pregnancy, the overall PPV was 79.3% (95% CI: 74.3–83.8). The overall PPVs of pregnancy-related VTE diagnoses were moderate to high. The predictive values varied substantially between the individual codes, however, and not all the registered VTE events occurred in relation to pregnancy. Thus, use of unvalidated registry-based pregnancy-related VTE diagnoses for epidemiological research may lead to biased results.

• Publisher: Elsevier Inc,Elsevier,Elsevier Limited
• Subject: Biological and medical sciences / Codes / Cor pulmonale / Denmark - epidemiology / Diseases of mother, fetus and pregnancy / Epidemiology / Female / General aspects / Gynecology. Andrology. Obstetrics / Hospitals / Humans / International Classification of Diseases / Medical Records - classification / Medical Records - standards / Medical sciences / Methodology / Patient Discharge - statistics & numerical data / Phlebitis / Predictive Value of Tests / Pregnancy / Pregnancy Complications, Cardiovascular - classification / Pregnancy Complications, Cardiovascular - diagnosis / Pregnancy Complications, Cardiovascular - epidemiology / Pregnancy. Fetus. Placenta / Public health. Hygiene / Public health. Hygiene-occupational medicine / Puerperal Disorders - classification / Puerperal Disorders - diagnosis / Puerperal Disorders - epidemiology / Puerperium / Pulmonary Embolism - classification / Pulmonary Embolism - diagnosis / Pulmonary Embolism - epidemiology / Pulmonary embolisms / Registries - standards / Thromboembolism / Thrombosis / Utilization Review / Validity / Venous thromboembolism / Venous Thrombosis - classification / Venous Thrombosis - diagnosis / Venous Thrombosis - epidemiology