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. 2020 Dec 1:12:1313-1325.
doi: 10.2147/CLEP.S267583. eCollection 2020.

The Validity of Intracerebral Hemorrhage Diagnoses in the Danish Patient Registry and the Danish Stroke Registry

Stine Munk Hald  1   2 , Christine Kring Sloth  1 , Mikkel Agger  1 , Maria Therese Schelde-Olesen  1 , Miriam Højholt  1 , Mette Hasle  1 , Helle Bogetofte  1 , Ida Olesrud  1 , Stefanie Binzer  3 , Charlotte Madsen  1 , Willy Krone  4 , Luis Alberto García Rodríguez  5 , Rustam Al-Shahi Salman  6 , Jesper Hallas  7 , David Gaist  1   2   8
Affiliations

The Validity of Intracerebral Hemorrhage Diagnoses in the Danish Patient Registry and the Danish Stroke Registry

Stine Munk Hald et al. Clin Epidemiol. .

Abstract

Purpose: To establish the validity of intracerebral hemorrhage (ICH) diagnoses in the Danish Stroke Registry (DSR) and the Danish National Patient Registry (DNPR).

Patients and methods: Based on discharge summaries and brain imaging reports, we estimated the positive predictive value (PPV) of a first-ever diagnosis code for ICH (ICD-10, code I61) for all patients in the Region of Southern Denmark (1.2 million) during 2009-2017 according to either DNPR or DSR. We estimated PPVs for any non-traumatic ICH (a-ICH) and spontaneous ICH (s-ICH) alone (ie, without underlying structural cause). We also calculated the sensitivity of these diagnoses in each of the registers. Finally, we classified the location of verified s-ICH.

Results: A total of 3,956 patients with ICH diagnosis codes were studied (DSR only: 87; DNPR only: 1,513; both registries: 2,356). In the DSR, the PPVs were 86.5% (95% CI=85.1-87.8) for a-ICH and 81.8% (95% CI=80.2-83.3) for s-ICH. The PPVs in DNPR (discharge code, primary diagnostic position) were 76.2% (95% CI=74.7-77.6) for a-ICH and 70.2% (95% CI=68.6-71.8) for s-ICH. Sensitivity for a-ICH and s-ICH was 76.4% (95% CI=74.8-78.0) and 78.7% (95% CI=77.1-80.2) in DSR, and 87.3% (95% CI=86.0-88.5) and 87.7% (95% CI=86.3-88.9) in DNPR. The location of verified s-ICH was lobar (39%), deep (33.6%), infratentorial (13.2%), large unclassifiable (11%), isolated intraventricular (1.9%), or unclassifiable due to insufficient information (1.3%).

Conclusion: The validity of a-ICH diagnoses is high in both registries. For s-ICH, PPV was higher in DSR, while sensitivity was higher in DNPR. The location of s-ICH was similar to distributions seen in other populations.

Keywords: epidemiology; intracerebral hemorrhage; register-based research; stroke; validity.

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Conflict of interest statement

The activities of DG are supported by a grant from Odense University Hospital. Luis Alberto García Rodríguez reports grants from Bayer AG, personal fees from Bayer AG, outside the submitted work. Rustam Al-Shahi Salman reports grants from British Heart Foundation, grants from The Stroke Association, outside the submitted work. The authors report no other potential conflicts of interest in this work.

Figures

Figure 1
Figure 1
Identification of patient records for validation from the DSR and DNPR.
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