Validity of initial cancer diagnoses in the Diagnosis Procedure Combination data in Japan

Shigemi, Daisuke; Morishima, Toshitaka; Yamana, Hayato; Yasunaga, Hideo; Miyashiro, Isao

doi:10.1016/j.canep.2021.102016

Cited by 47 publications

(43 citation statements)

References 20 publications

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“…The physicians input patients' diagnosis into the DPC database according to International Classification of Diseases, 10th revision (ICD‐10). The DPC database has been used for various clinical studies, 16,18 including those for colorectal cancer, 17 and its diagnostic validity is confirmed 20,22 …”

Section: Methodsmentioning

confidence: 97%

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Effectiveness of colonic stent placement for obstructive colorectal cancers: An analysis of short‐term results using a nationwide database in Japan

Moroi

Tarasawa

Kuroha

et al. 2022

J of Gastro and Hepatol

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Background and Aims Self‐expandable metallic stent (SEMS) is widely used for obstructive colorectal cancer (OCC). Both SEMS and urgent surgery have several merits and demerits. This study aimed to clarify the efficacy of SEMS by comparing the mortality rate after the hospitalization between SEMS and urgent surgery for OCC. Methods We collected OCC patients' data using the Diagnosis Procedure Combination (DPC) database system. We divided eligible patients into the SEMS and urgent surgery groups using propensity score matching and compared in‐hospital death rates, length of hospitalization, and medical costs. We also conducted logistic regression analysis to identify clinical factors affecting in‐hospital deaths. Results We enrolled 17 140 cases after propensity score matching. SEMS reduced the in‐hospital death rate compared with urgent surgery (2.0% vs 3.6%, P < 0.0001). Length of hospitalization was shorter in the SEMS group than in the urgent surgery group (16 vs 25 days, P < 0.0001). Medical costs were lower in the SEMS group than in the urgent surgery group (1 663 550 vs 2 424 082 JPY, P < 0.0001). Multivariate analysis also showed that SEMS reduced in‐hospital death (odds ratio = 0.58, 95% confidence interval: 0.50–0.70, P < 0.0001). Conclusion Self‐expandable metallic stent placement for OCC might reduce the mortality rate in short term and shorten the length of hospitalization. These results facilitate considering SEMS with careful judgment for its indication when treating OCC patients.

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Section: Methodsmentioning

confidence: 97%

“…The DPC database has been used for various clinical studies, 16,18 including those for colorectal cancer, 17 and its diagnostic validity is confirmed. 20,22 The DPC database cannot identify the patients who discharged after SEMS placement and subsequently readmitted another hospital to undergo surgery.…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of colonic stent placement for obstructive colorectal cancers: An analysis of short‐term results using a nationwide database in Japan

Moroi

Tarasawa

Kuroha

et al. 2022

J of Gastro and Hepatol

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“…14 Validation of various diagnostic records in this database was conducted to a high standard. 15,16 The sensitivity and specificity of the primary diagnoses were 78.9% and 93.2%, respectively. 16…”

Section: Study Design and Data Sourcementioning

confidence: 96%

Resuscitative endovascular balloon occlusion of the aorta for life-threatening postpartum hemorrhage: A nationwide observational study in Japan

Kamijo

Nakajima

Shigemi

et al. 2022

J Trauma Acute Care Surg

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BACKGROUND:Resuscitative endovascular balloon occlusion of the aorta (REBOA) is used for postpartum hemorrhage (PPH), which is one of the leading causes of maternal mortality worldwide; however, its utility in the obstetrics setting remains unclear. Thus, this study aimed to describe the characteristics, demographics, and mortality of patients with PPH who underwent REBOA. METHODS:We used the Japanese Diagnosis Procedure Combination inpatient database to identify patients with PPH who underwent REBOA from April 2012 to March 2020. We examined the patients' characteristics, interventions administered, and in-hospital mortality. RESULTS:We identified 143 patients with PPH who underwent REBOA. The most common cause of PPH was atonic postpartum hemorrhage (52.4%), followed by disseminated intravascular coagulation (29.4%) and amniotic fluid embolism documented (11.2%). Among patients who delivered at hospitals in which REBOA was performed (n = 55), 38.2% of patients experienced preterm births, and 70.9% delivered via cesarean delivery. The proportion of patients who underwent transcatheter arterial embolization and hysterectomy was 53.8% and 16.1%, respectively. In-hospital mortality was 7.0%. CONCLUSION:The results of the present study could be helpful in clinical decision making and providing patients and families with additional treatment options for PPH. (

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“…Therefore, the diagnosis may uncertain. However, the diagnostic accuracy of DPC is moderate or high (43,44), and previous studies using database have also used the ICD codes (25,32). We used information on antivirals for HZ to improve diagnostic accuracy.…”

Section: Limitationsmentioning

confidence: 99%

Short-Term Prognostic Factors in Hospitalized Herpes Zoster Patients and Its Associated Cerebro-Cardiovascular Events: A Nationwide Retrospective Cohort in Japan

et al. 2022

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BackgroundShort-term mortality and incidence of cerebrovascular and cardiovascular events (C-CVE) during hospitalization of patients with severe herpes zoster (HZ) have not been sufficiently investigated. We aimed to investigate short-term prognosis and incidence of C-CVE associated with HZ in hospitalized patients.MethodsThis retrospective cohort study from April 2016 to March 2018 included HZ inpatient cases selected from the Diagnosis Procedure Combination database—a Japanese nationwide inpatient database. HZ and C-CVE were diagnosed based on the 10th revision of the International Classification of Diseases and Injuries codes. The definition of primary exposure was that treatments were initiated within 7 days of admission, and antivirals were administered for ≥7 days. Main Outcomes were in-hospital deaths and C-CVE onset after hospitalization.ResultsAmong 16,811,501 in-hospital cases registered from 1,208 hospitals, 29,054 cases with HZ were enrolled. The median age was 71.0 years, 15,202 cases (52.3%) were female, and the HZ types were the central nervous system (n=9,034), disseminated (n=3,051), and ophthalmicus (n=1,069) types. There were 301 (1.0%) in-hospital deaths and 385 (1.3%) post-hospitalization onset of C-CVE. The 30-day in-hospital survival rates with or without underlying disease were 96.8% and 98.5%, respectively. Age ≥75 years (hazard ratio [HR], 2.18; 95% confidence interval [CI], 1.55–3.05), liver cirrhosis or hepatic failure (HR, 5.93; 95% CI, 2.16–16.27), chronic kidney disease (HR, 1.82; 95% CI, 1.24–2.68), heart failure (HR, 1.65; 95% CI, 1.22–2.24), and old cerebrovascular events (HR, 1.92; 95% CI, 1.10–3.34) were associated with poor short-term prognosis. Age ≥75 years (odds ratio [OR], 1.70; 95% CI, 1.29–2.24), diabetes (OR, 1.50; 95% CI, 1.19–1.89), dyslipidemia (OR, 1.95; 95% CI, 1.51–2.51), hyperuricemia (OR, 1.63; 95% CI, 1.18–2.27), hypertension (OR, 1.76; 95% CI, 1.40–2.20), heart failure (OR, 1.84; 95% CI, 1.32–2.55), and glucocorticoid administration (OR, 1.59; 95% CI, 1.25–2.01) were associated with increased risks for in-hospital C-CVE onset.ConclusionsThe underlying diseases that could influence the short-term mortality of severe HZ were identified. Glucocorticoid is a possible risk factor for the in-hospital onset of C-CVE after severe HZ development.

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Validity of initial cancer diagnoses in the Diagnosis Procedure Combination data in Japan

Cited by 47 publications

References 20 publications

Effectiveness of colonic stent placement for obstructive colorectal cancers: An analysis of short‐term results using a nationwide database in Japan

Effectiveness of colonic stent placement for obstructive colorectal cancers: An analysis of short‐term results using a nationwide database in Japan

Resuscitative endovascular balloon occlusion of the aorta for life-threatening postpartum hemorrhage: A nationwide observational study in Japan

Short-Term Prognostic Factors in Hospitalized Herpes Zoster Patients and Its Associated Cerebro-Cardiovascular Events: A Nationwide Retrospective Cohort in Japan

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