ICD-9 codes underestimate statin-linked rhabdomyolysis

April 18, 2012
<i>ICD-9</i> codes underestimate statin-Linked rhabdomyolysis

(HealthDay) -- Use of diagnostic codes, such as International Classification of Diseases -- Ninth Revision (ICD-9) codes, may result in misclassification of rare, adverse drug reactions (ADRs), including the risk of rhabdomyolysis from high-dose simvastatin, according to a research letter published in the April 18 issue of the Journal of the American Medical Association, a theme issue on comparative effectiveness research.

To assess the use of diagnostic codes as a method of estimating statin-related rhabdomyolysis and myopathy, James S. Floyd, M.D., of the University of Washington in Seattle, and colleagues reviewed the full for patients from the Group Health Cooperative who had a statin prescription within three months of an ICD-9 code for rhabdomyolysis or an ADR.

The researchers found that among the 292 statin users with an ICD-9 code for rhabdomyolysis, 29 cases were identified and validated. None of the 29 cases died; 90 percent were hospitalized and 29 percent had at least a doubling of serum creatinine levels. Using the ICD-9 code, the rhabdomyolysis incidence rate ratio (IRR) for simvastatin versus other statins was 2.61 versus 1.03. For a dose of simvastatin of 80 mg per day or greater versus 20 to 39 mg per day, the IRR was 12.2 for validated cases and 1.77 using the ICD-9 code for rhabdomyolysis.

"These results confirm in a community setting findings from a recent clinical trial that prompted the U.S. to issue a warning about the use of high-dose simvastatin," the authors write. "The ICD-9 code for rhabdomyolysis was nonspecific for this ADR, and the resulting misclassification markedly attenuated the estimated relative risk for high-dose versus low-dose simvastatin."

One of the authors disclosed to the medical device/technology industries.

Explore further: FDA announces new limits on high-dose simvastatin (Zocor)

More information: Abstract
Full Text (subscription or payment may be required)

Related Stories

FDA announces new limits on high-dose simvastatin (Zocor)

June 9, 2011
The United States Food and Drug Administration (FDA) today announced new limitations to the use of high-dose simvastatin, due to the increased risk of muscle pain and weakness (myopathy) and in rare cases, kidney damage and ...

Intensive-dose statin therapy associated with increased risk of diabetes

June 21, 2011
An analysis of data from previously published studies indicates that intensive-dose statin therapy is associated with an increased risk of new-onset diabetes compared with moderate-dose therapy, according to a study in the ...

Early clinical data show galeterone safe, effective against prostate cancer

April 1, 2012
Patients with castration-resistant prostate cancer had limited side effects and in many cases a drop in prostate-specific antigen expression with galeterone (TOK-001), a small-molecule oral drug, according to phase I data ...

Recommended for you

Mind-body therapies immediately reduce unmanageable pain in hospital patients

July 25, 2017
Mindfulness training and hypnotic suggestion significantly reduced acute pain experienced by hospital patients, according to a new study published in the Journal of General Internal Medicine.

Study suggests ending opioid epidemic will take years

July 20, 2017
The question of how to stem the nation's opioid epidemic now has a major detailed response. A new study chaired by University of Virginia School of Law Professor Richard Bonnie provides extensive recommendations for curbing ...

Team-based model reduces prescription opioid use among patients with chronic pain by 40 percent

July 17, 2017
A new, team-based, primary care model is decreasing prescription opioid use among patients with chronic pain by 40 percent, according to a new study out of Boston Medical Center's Grayken Center for Addiction Medicine, which ...

Private clinics' peddling of unproven stem cell treatments is unsafe and unethical

July 7, 2017
Stem cell science is an area of medical research that continues to offer great promise. But as this week's paper in Science Translational Medicine highlights, a growing number of clinics around the globe, including in Australia, ...

Popular heartburn drugs linked to higher death risk

July 4, 2017
Popular heartburn drugs called proton pump inhibitors (PPIs) have been linked to a variety of health problems, including serious kidney damage, bone fractures and dementia. Now, a new study from Washington University School ...

Most reproductive-age women using opioids also use another substance

June 30, 2017
The majority of reproductive-age and pregnant women who use opioids for non-medical purposes also use at least one other substance, ranging from nicotine or alcohol to cocaine, according to a University of Pittsburgh Graduate ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.