Identification of Stevens-Johnson syndrome and toxic epidermal necrolysis in electronic health record databases.
Identification of Stevens-Johnson syndrome and toxic epidermal necrolysis in electronic health record databases.
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DOI：
10.1002/pds.3778
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发表时间：
2015-07
影响因子：
2.6
通讯作者：
Pinheiro SP
中科院分区：
文献类型：
--
作者：
Davis RL;Gallagher MA;Asgari MM;Eide MJ;Margolis DJ;Macy E;Burmester JK;Selvam N;Boscarino JA;Cromwell LF;Feigelson HS;Kuntz JL;Pawloski PA;Penfold RB;Raebel MA;Sridhar G;Wu A;La Grenade LA;Pacanowski MA;Pinheiro SP
Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) carry a high mortality risk. While identifying clinical and genetic risk factors for these conditions has been hindered by their rarity, large electronic health databases hold promise for identifying large numbers of cases for study, especially with the introduction in 2008 of ICD-9 codes more specific for these conditions. The objective of this study is to estimate the validity of ICD-9 codes for ascertaining SJS/TEN in 12 collaborating research units in the USA, covering almost 60 million lives. From the electronic databases at each site, we ascertained potential cases of SJS/TEN using ICD-9 codes. At five sites, a subset of medical records was abstracted and standardized criteria applied by board-certified dermatologists to adjudicate diagnoses. Multivariate logistic regression was used to identify factors independently associated with validated SJS/TEN cases. A total of 56 591 potential cases of SJS/TEN were identified. A subset of 276 charts was selected for adjudication and 39 (of the 276) were confirmed as SJS/TEN. Patients with the ICD-9 codes introduced after 2008 were more likely to be confirmed as cases (OR 3.32; 95%CI 0.82, 13.47) than those identified in earlier years. Likelihood of case status increased with length of hospitalization. Applying the probability of case status to the 56 591 potential cases, we estimated 475–875 to be valid SJS/TEN cases. Newer ICD-9 codes, along with length of hospitalization, identified patients with a high likelihood of SJS/TEN. This is important for identification of subjects for future pharmacogenomics studies. The combination of newly introduced ICD-9 codes, along with length of hospitalization, strongly predicts SJS/TEN case status. This information could be critical for studies interested in identifying large numbers of cases for pharmacogenomic study.
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影响因子：
158.5
作者：
Chen, Pei;Lin, Juei-Jueng;Shen, Chen-Yang
通讯作者：
Shen, Chen-Yang
影响因子：
--
作者：
CHAN, HL;STERN, RS;WALKER, AM
通讯作者：
WALKER, AM
影响因子：
--
作者：
STROM, BL;CARSON, JL;STOLLEY, PD
通讯作者：
STOLLEY, PD
影响因子：
2.8
作者：
Lonjou, C.;Thomas, L.;Roujeau, J. -C.
通讯作者：
Roujeau, J. -C.
DOI：
10.4103/0378-6323.57718
发表时间：
2009-11-01
影响因子：
2.9
作者：
Mehta, Timir Y.;Prajapati, Laxman M.;Goyal, Ramesh K.
通讯作者：
Goyal, Ramesh K.