Predictive value of pediatric thrombosis diagnoses in the Danish National Patient Registry

Ruta Tuckuviene¹, Soeren Risom Kristensen¹, Jon Helgestad², Anette Luther Christensen¹, Soeren Paaske Johnsen³

¹Department of Clinical Biochemistry, Center for Cardiovascular Research, ²Department of Pediatrics, ³Department of Clinical Epidemiology, Aarhus University Hospital, Aalborg and Aarhus, Denmark

Abstract: Data on the validity of pediatric thrombosis diagnoses are missing. We aimed to examine the predictive value of a diagnosis of venous and arterial thrombosis using the Danish National Patient Registry (DNPR). We identified all first-time diagnoses among children and adolescents (aged 0–18 years) between 1994 and 2006 in DNPR. In total, 1138 potential cases of thrombosis were identified; the medical records were retrieved for 1112 (97.7%) and the positive predictive value (PPV) computed. Overall, the diagnosis of thrombosis was verified in 598 of the 1112 cases, corresponding to a PPV of 53.7% (95% confidence interval [CI]: 50.8–56.7). Diagnoses from wards had the PPV of 62.5% (95% CI: 59.4–65.6). The predictive value of a thrombosis diagnosis from wards was age-dependent, with a higher PPV (77.4%, 95% CI: 68.7–84.7) in neonates (<28 days) and adolescents (15–18 years) (68.2%; 95% CI: 63.2–72.5)) than in children (28 days–14 years) (51.2%; (95% CI: 46.0–56.4)). The PPV of a thrombosis diagnosis was improved by restricting the analysis to diagnoses from wards, primary diagnoses, and admissions with a length of stay of three or more days. The results indicate that an interpretation of nonvalidated hospital discharge data for pediatric thrombosis in a registry like DNPR should be made with caution.

Keywords: pediatric thrombosis, discharge diagnosis, registry, positive predictive value