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Association of Antithrombotic Drug Use with Subdural Hematoma Risk

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Association of Antithrombotic Drug Use with Subdural Hematoma Risk Supplementary Online Content Gaist D, García Rodríguez LA, Hellfritzsch M, et al. Association of antithrombotic drug use with subdural hematoma risk. JAMA. doi:10.1001/jama.2017.0639 eTable 1. List of codes used to retrieve and classify data for the study eTable 2. Single use of antithrombotic drugs and risk of subdural hematoma in Denmark, 2000- 2015 eTable 3. First-time use of antithrombotic drugs and risk of subdural hematoma, Denmark, 2000- 2015 eTable 4. Antithrombotic drug use and risk of subdural hematoma within sex and age strata, Denmark, 2000-2015 eTable 5. Antithrombotic drug use and risk of subdural hematoma, Funen area, 2000-2012 eTable 6. Association between subdural hematoma type and preadmission antithrombotic drug use, Funen area, 2000-2012 eTable 7. Association between subdural hematoma and preadmission antithrombotic drug use stratified by severity of head trauma in cases, Funen area, 2000-2012 eTable 8. Association between subdural hematoma imaging characteristics and preadmission antithrombotic drug use in cases, Funen area, 2000-2012 eTable 9. Association between subdural hematoma surgical treatment, 30-day mortality, and preadmission antithrombotic drug use in cases, Funen area, 2000-2012 eTable 10. Incidence rate of subdural hematoma and percentage of subdural hematoma patients with current use of antithrombotic drugs in Denmark, 2000-2015 eMethods eFigure 1. Short-term (30-day) mortality after subdural hematoma diagnosis stratified by age, Denmark, 2000-2015 eFigure 2. Crude and age- and sex standardized incidence rate of subdural hematoma (panel A) and 30-day mortality after subdural hematoma diagnosis (panel B), Denmark, 2000-2015 eReferences This supplementary material has been provided by the authors to give readers additional information about their work. © 2017 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/30/2021 eTable 1. List of codes used to retrieve and classify data for the study HOSPITAL CODES (DISCHARGE, OUTPATIENT, PROCEDURES) Outcome of interest Subdural hematoma (SDH) ICD-8: 852.01, 852.11, 431.01, 431.91 [only used to exclude prevalent cases] ICD-10: S065 Surgical procedures Burr hole: AAD10 Craniotomy: AAD05 Covariates1 Stroke (hemorrhagic, ischaemic, or “unspecified”) ICD-8 : 43100, 43108, 43109,43190, 43198, 43199, 433, 434, 43601, 43609, 43690 ICD-10: I61, I63, I64.9 Epilepsy ICD-8: 345 ICD-10: G40, G41 Dementia ICD-8: 29009, 29010, 29011, 29018, 29019, 29309 ICD-10: F00, F01, F02, F03, F05.1 Myocardial infarct ICD-8: 410 ICD-10: I21 Unstable angina ICD-8: No code available ICD-10: I20.0 Angina, other ICD-8: 413.09, 413.99 ICD-10: I20.1-I20.9 Peripheral artery disease ICD-8: 443.89 ICD-10: I73.9 Diabetes ICD-8: 249, 250 ICD-10: E10-E14 COPD ICD-8: 49000, 49100, 49101, 49103 ICD-10: J42, J43, J44 Hypertension ICD-8: 400-404 ICD-10: I10-I15 Chronic renal insufficiency ICD-8: 593.2 ICD-10: N18-N19 Chronic hepatic diseases ICD-8: 571.11, 571.19, 571.90, 571.91, 571.92, 571.93, 571.94, 571.99, 573 ICD-10: K71-K77 Coagulopathy ICD-8: 286.09, 286.19, 286.29, 286.39, 286.99 ICD-10: D66, D67, D680, D681, D682, D689, D691, D693, D694 Codes of disorders indicative of alcohol misuse ICD-8: 291, 303, 571.09, 571.10, 577.10, 979, 980 ICD-10: F10, G312, G621, G721, I426, K292, K70, K860, R780, T51, Z721 © 2017 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/30/2021 ATC CODES Antiplatelet drugs2 Aspirin – low-dose B01AC06 – acetylsalicylic acid (75 mg, 100 mg, or 150 mg per tablet) B01AC30 – acetylsalicylic acid (50 mg per tablet) in combination with dipyridamole Dipyridamole B01AC07 (100 mg per tablet, or 200 mg per tablet) Clopidogrel B01AC04 (75 mg per tablet) Other ADP drugs B01AC22 – prasugrel (5 mg, or 10 mg per tablet) B01AC24 - ticagrelor (60 mg, or 90 mg per tablet) Anticoagulant drugs2 Vitamin K antagonists B01AA Direct oral anticoagulants (DOAC) Dabigatran etexilate B01AE07 Rivaroxaban B01AF01 Apixaban B01AF02 Nonsteroidal anti-inflammatory drugs (NSAIDs)3 M01A (including Cox2 inhibitors), excluding M01AX Selective serotonin reuptake inhibitors (SSRI)3 N06AB Antidiabetics3 A10 Antihypertensives3 Diuretics C03 (except loop-diuretics, C03C) Beta-blockers C07 Calcium antagonists C08 (except verapamil & diltiazem) Agents that influence the renin-angiotensin system C09 Drugs used in treatment of Alzheimer’s disease and other types of dementia3 Cholinesterase inhibitors N06DA Memantin N06DX01 Statins3 C10AA Postmenopausal hormone replacement therapy3 G03C, G03DC, G03F Oral corticosteroids3 H02AB Drugs used in treatment of alcohol dependency2 N07BB Hypnotics and sedatives (including benzodiazepines)3 N05BA, N05C 1Based on hospital contacts in period 1977 to 1 month prior to index date. 2Based on prescriptions presented 1st January 1995 to 1 day prior to index date. 3Based on presciptions presented in period 1 year to 1 month prior to index date. © 2017 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/30/2021 eTable 2. Single use of antithrombotic drugs and risk of subdural hematoma in Denmark, 2000-2015 Cases, no. (%) Controls, no. (%) OR1 adjusted OR2 (n=10,010) (n=400,380) (95% CI) (95% CI) Antiplatelet drugs Never use of any antithrombotic drug 5,013 (50.1) 252,593 (63.1) 1.00 (reference) 1.00 (reference) Low-dose aspirin – current use 1,563 (15.6) 67,416 (16.8) 1.33 (1.25-1.42) 1.19 (1.10-1.29) Duration of current use <1 month 122 (1.2) 2,364 (0.6) 3.04 (2.50-3.68) 2.70 (2.19-3.32) ≥1 month, ≤3 months 135 (1.3) 4,638 (1.2) 1.65 (1.38-1.97) 1.43 (1.18-1.74) >3 months, ≤12 months 404 (4.0) 15,712 (3.9) 1.44 (1.29-1.60) 1.21 (1.07-1.37) >1 year, ≤3 years 447 (4.5) 20,683 (5.2) 1.24 (1.11-1.37) 1.07 (0.95-1.21) >3 years 455 (4.5) 24,019 (6.0) 1.11 (1.00-1.23) 0.92 (0.81-1.04) Clopidogrel – current use 199 (2.0) 4,045 (1.0) 2.98 (2.55-3.50) 1.61 (1.30-1.98) Duration of current use <1 month 9 (0.1) 134 (0.0) 4.24 (2.05-8.75) 2.13 (0.98-4.65) ≥1 month, ≤3 months 16 (0.2) 254 (0.1) 3.45 (2.02-5.92) 1.74 (0.97-3.14) >3 months, ≤12 months 42 (0.4) 816 (0.2) 3.25 (2.33-4.53) 1.48 (1.02-2.16) >1 year, ≤3 years 84 (0.8) 1,807 (0.5) 2.83 (2.23-3.58) 1.45 (1.08-1.93) >3 years 48 (0.5) 1,034 (0.3) 2.82 (2.07-3.85) 1.44 (1.00-2.08) Oral anticoagulant drugs DOAC3 – current use 44 (0.4) 1,276 (0.3) 2.13 (1.53-2.96) 1.78 (1.26-2.53) Duration of current use <1 month 3 (0.0) 86 (0.0) 2.07 (0.63-6.85) NA4 ≥1 month, ≤3 months 7 (0.1) 153 (0.0) 2.77 (1.23-6.22) 2.72 (1.16-6.35) >3 months, ≤12 months 9 (0.1) 355 (0.1) 1.60 (0.80-3.19) 1.27 (0.62-2.60) >1 year, ≤3 years 23 (0.2) 571 (0.1) 2.56 (1.64-4.01) 2.05 (1.27-3.32) >3 years (n<3) 111 (0.03) NA4 NA4 © 2017 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/30/2021 Cases, no. (%) Controls, no. (%) OR1 adjusted OR2 (n=10,010) (n=400,380) (95% CI) (95% CI) Oral anticoagulant drugs VKA5 – current use 853 (8.5) 12,940 (3.2) 3.99 (3.67-4.34) 3.51 (3.19-3.87) Duration of current use <1 month 36 (0.4) 562 (0.1) 3.51 (2.45-5.02) 2.76 (1.88-4.06) ≥1 month, ≤3 months 94 (0.9) 1,087 (0.3) 5.12 (4.06-6.45) 4.32 (3.36-5.54) >3 months, ≤12 months 193 (1.9) 2,732 (0.7) 4.14 (3.53-4.86) 3.42 (2.87-4.08) >1 year, ≤3 years 225 (2.2) 3,356 (0.8) 3.91 (3.37-4.53) 3.33 (2.82-3.92) >3 years 305 (3.0) 5,203 (1.3) 3.57 (3.14-4.07) 3.14 (2.72-3.63) Single current users were defined as subjects with current use of a single antithrombotic drug and no concurrent use of other antithrombotic drugs or previous use (in the 12 months preceding their index date) of other antithrombotic drugs. 1Adjusted for age, sex, and calendar period (year) by design 2Adjusted for age, sex, and calendar period (by design) and the following, based on register data: hypertension, stroke, epilepsy, dementia, chronic obstructive pulmonary disease, high alcohol consumption, chronic hepatic disease, chronic renal insufficiency, diabetes, myocardial infarct, angina, unstable angina, peripheral artery disease, use of nonsteroidal anti- inflammatory drugs, selective serotonin reuptake inhibitors, hypnotics and sedatives, hormone replacement therapy, oral corticosteroid drugs, and socioeconomic status (education level and income). Analyses for low-dose aspirin were adjusted for current use of clopidogrel and vice-versa. Analyses for antiplatelet drugs were adjusted for current use of oral anticoagulant drugs and vice- versa. 3Direct oral anticoagulant 4Not applicable 5Vitamin K antagonist © 2017 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/30/2021 eTable 3.
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