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Validation of hospital discharge diagnoses for hypertensive disorders of pregnancy

Acta obstetricia et gynecologica Scandinavica, 2016-11, Vol.95 (11), p.1288-1294 [Peer Reviewed Journal]

2016 Nordic Federation of Societies of Obstetrics and Gynecology ;2016 Nordic Federation of Societies of Obstetrics and Gynecology. ;Acta Obstetricia et Gynecologica Scandinavica © 2016 Nordic Federation of Societies of Obstetrics and Gynecology ;ISSN: 0001-6349 ;EISSN: 1600-0412 ;DOI: 10.1111/aogs.13006 ;PMID: 27562930 ;CODEN: AOGSAE

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Title:
Validation of hospital discharge diagnoses for hypertensive disorders of pregnancy
Author: Luef, Birgitte M. ; Andersen, Louise B. ; Renäult, Kristina M. ; Nohr, Ellen A. ; Jørgensen, Jan S. ; Christesen, Henrik T.
Subjects: Denmark - epidemiology ; Diagnostic Errors - statistics & numerical data ; Electronic Health Records ; Female ; High-risk Pregnancy ; Humans ; hypertension in pregnancy ; Hypertension, Pregnancy-Induced - diagnosis ; Hypertension, Pregnancy-Induced - epidemiology ; obesity ; Patient Discharge ; pre-eclampsia ; Predictive Value of Tests ; Pregnancy ; Prevalence ; Registries ; Retrospective Studies ; Sensitivity and Specificity
Is Part Of: Acta obstetricia et gynecologica Scandinavica, 2016-11, Vol.95 (11), p.1288-1294
Description: Introduction A correct diagnosis of preeclampsia and gestational hypertension is important for treatment and epidemiological studies. Changes in diagnostic criteria and underreporting in certain subsets of patients may hamper validity of the diagnoses. Materials and Methods We validated the discharge diagnoses of preeclampsia and gestational hypertension, which are reported to the Danish National Patient Registry, in a cohort of 2163 pregnant women by retrospective evaluation of electronic hospital data. Results A preeclampsia discharge diagnosis was found in 113 (5.2%) of the participants. After validation, significantly more patients fulfilled criteria for diagnosis of preeclampsia (n = 163, 7.5%, p = 0.002); more had severe preeclampsia, 14 (0.6%) vs. 70 (3.2%), p < 0.001 and gestational hypertension, 62 (2.9%) vs. 46 (2.1%), p = 0.12. The diagnostic sensitivity for preeclampsia by discharge diagnosis was 55.8%; severe preeclampsia 18.6%; gestational hypertension 39.1%. Corresponding positive predictive values were 80.5, 92.9 and 29.0%. Misclassification occurred in 4.3, 2.7 and 3.3%, respectively. Misclassification was more prevalent in obese compared to lean women (10% vs. 3.6%, p < 0.0001). Conclusions Discharge diagnoses substantially underestimated the prevalence of preeclampsia, especially severe preeclampsia. Misclassification was most common in obese preeclamptic women. These findings depict the limitations associated with the direct use of discharge diagnoses of hypertensive disorders in pregnancy for research purposes.
Publisher: United States: Blackwell Publishing Ltd
Language: English;French;German
Identifier: ISSN: 0001-6349
EISSN: 1600-0412
DOI: 10.1111/aogs.13006
PMID: 27562930
CODEN: AOGSAE
Source: Journals@Ovid Open Access Journal Collection Rolling
MEDLINE
Alma/SFX Local Collection

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Validation of hospital discharge diagnoses for hypertensive disorders of pregnancy

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