Diagnostic accuracy, clinical characteristics, and prognostic differences of patients with acute myocarditis according to inclusion criteria.

IF 4.8 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Roman Roy, Antonio Cannata, Mohammad Al-Agil, Emma Ferone, Antonio Jordan, Brian To-Dang, Matthew Sadler, Aamir Shamsi, Mohammad Albarjas, Susan Piper, Mauro Giacca, Ajay M Shah, Theresa McDonagh, Daniel I Bromage, Paul A Scott
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引用次数: 0

Abstract

Introduction: The diagnosis of acute myocarditis (AM) is complex due to its heterogeneity and typically is defined by either Electronic Healthcare Records (EHRs) or advanced imaging and endomyocardial biopsy, but there is no consensus. We aimed to investigate the diagnostic accuracy of these approaches for AM.

Methods: Data on ICD 10th Revision(ICD-10) codes corresponding to AM were collected from two hospitals and compared to cardiac magnetic resonance (CMR)-confirmed or clinically suspected (CS)-AM cases with respect to diagnostic accuracy, clinical characteristics, and all-cause mortality. Next, we performed a review of published AM studies according to inclusion criteria.

Results: We identified 291 unique admissions with ICD-10 codes corresponding to AM in the first three diagnostic positions. The positive predictive value of ICD-10 codes for CMR-confirmed or CS-AM was 36%, and patients with CMR-confirmed or CS-AM had a lower all-cause mortality than those with a refuted diagnosis (P = 0.019). Using an unstructured approach, patients with CMR-confirmed and CS-AM had similar demographics, comorbidity profiles and survival over a median follow-up of 52 months (P = 0.72). Our review of the literature confirmed our findings. Outcomes for patients included in studies using CMR-confirmed criteria were favourable compared to studies with endomyocardial biopsy-confirmed AM cases.

Conclusion: ICD-10 codes have poor accuracy in identification of AM cases and should be used with caution in clinical research. There are important differences in management and outcomes of patients according to the selection criteria used to diagnose AM. Potential selection biases must be considered when interpreting AM cohorts and requires standardization of inclusion criteria for AM studies.

根据纳入标准,急性心肌炎患者的诊断准确性、临床特征和预后差异。
引言:急性心肌炎(AM)的诊断由于其异质性而复杂,通常由电子医疗记录(EHR)或高级成像和心肌内活检来定义,但尚未达成共识。我们旨在研究这些方法对AM的诊断准确性。方法:从两家医院收集与AM相对应的ICD第10版(ICD-10)代码的数据,并与CMR确诊或临床疑似(CS)AM病例在诊断准确性、临床特征和全因死亡率方面进行比较。接下来,我们根据纳入标准对已发表的AM研究进行了综述。结果:我们确定了291例在前三个诊断位置具有与AM相对应的ICD-10代码的独特入院病例。ICD-10编码对CMR确诊或CS-AM的阳性预测值(PPV)为36%,CMR确诊患者或CS AM患者的全因死亡率低于未确诊患者(P=0.019)。使用非结构化方法,CMR确认患者和CS AM患者具有相似的人口统计学特征,中位随访52个月的共病特征和生存率(P=0.72)。我们对文献的回顾证实了我们的发现。与EMB确诊AM病例的研究相比,使用CMR确诊标准的研究中纳入的患者的结果是有利的。结论:ICD-10编码在AM病例识别中的准确性较差,临床研究中应谨慎使用。根据用于诊断AM的选择标准,患者的管理和结果存在重要差异。在解释AM队列时必须考虑潜在的选择偏差,并要求标准化AM研究的纳入标准。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
9.40
自引率
3.80%
发文量
76
期刊介绍: European Heart Journal - Quality of Care & Clinical Outcomes is an English language, peer-reviewed journal dedicated to publishing cardiovascular outcomes research. It serves as an official journal of the European Society of Cardiology and maintains a close alliance with the European Heart Health Institute. The journal disseminates original research and topical reviews contributed by health scientists globally, with a focus on the quality of care and its impact on cardiovascular outcomes at the hospital, national, and international levels. It provides a platform for presenting the most outstanding cardiovascular outcomes research to influence cardiovascular public health policy on a global scale. Additionally, the journal aims to motivate young investigators and foster the growth of the outcomes research community.
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