Validation of a computer case definition for sudden cardiac death in opioid users

BMC Research Notes

Wayne A Ray⁵  Kathi Hall⁴  David J Graham³  William O Cooper²  C Michael Stein¹  Katherine T Murray¹  Vivian K Kawai¹ 

[1] Clinical Pharmacology, Vanderbilt University, Nashville, TN, USA;Department of Pediatrics, Nashville, TN, USA;Food and Drug Administration, Silver Spring, MD, USA;Division of Pharmacoepidemiology, Department of Preventive Medicine, Nashville, TN, USA;Department of Preventive Medicine, Vanderbilt University, Village at Vanderbilt, Suite 2600, 1501 21st Ave South, Nashville, TN 37212, USA

关键词: Propoxyphene;    Opioids;    Sudden cardiac death;    Automated databases;    Case definition;   

Others  :  1165813
DOI  :  10.1186/1756-0500-5-473

 received in 2012-02-08, accepted in 2012-07-13,  发布年份 2012

【 摘 要 】

Background

To facilitate the use of automated databases for studies of sudden cardiac death, we previously developed a computerized case definition that had a positive predictive value between 86% and 88%. However, the definition has not been specifically validated for prescription opioid users, for whom out-of-hospital overdose deaths may be difficult to distinguish from sudden cardiac death.

Findings

We assembled a cohort of persons 30-74 years of age prescribed propoxyphene or hydrocodone who had no life-threatening non-cardiovascular illness, diagnosed drug abuse, residence in a nursing home in the past year, or hospital stay within the past 30 days. Medical records were sought for a sample of 140 cohort deaths within 30 days of a prescription fill meeting the computer case definition. Of the 140 sampled deaths, 81 were adjudicated; 73 (90%) were sudden cardiac deaths. Two deaths had possible opioid overdose; after removing these two the positive predictive value was 88%.

Conclusions

These findings are consistent with our previous validation studies and suggest the computer case definition of sudden cardiac death is a useful tool for pharmacoepidemiologic studies of opioid analgesics.

【 授权许可】

   
2012 Kawai et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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