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Comment & Response
November 2018

Can Stroke Complications Be Distinguished From Comorbid Stroke in Administrative Data?

Author Affiliations
  • 1Cerebrovascular Center, Cleveland Clinic, Cleveland, Ohio
JAMA Cardiol. 2018;3(11):1126. doi:10.1001/jamacardio.2018.2903

To the Editor Andreasen et al1 used the administrative database in Denmark to determine stroke complications with surgical aortic valve replacement (SAVR) among those with and without previous stroke. The authors observed a higher risk of stroke complications if SAVR was performed closer in time after stroke. A key issue in their methodology is identification of stroke complications, for which International Classification of Disease, Eight Revision (ICD-8) and ICD-10 codes were used. The authors referenced a study reporting a positive predictive value between 88% and 97% of ICD codes for diagnosis of ischemic stroke, but these are regarding strokes occurring in the Copenhagen City Heart Study cohort.2 This validation study did not look at stroke complications in hospitalizations or procedures.

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