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

• Main Authors: Kawai Vivian K, Murray Katherine T, Stein C, Cooper William O, Graham David J, Hall Kathi, Ray Wayne A
• Format: Article
• Language: English
• Published: BMC 2012-08-01
• Series: BMC Research Notes
• Subjects: Case definition; Automated databases; Sudden cardiac death; Opioids; Propoxyphene
• Online Access: http://www.biomedcentral.com/1756-0500/5/473

<p>Abstract</p> <p>Background</p> <p>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.</p> <p>Findings</p> <p>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%.</p> <p>Conclusions</p> <p>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.</p>