Supplementary Material s63
Supplementary material
Table A1. Codes used in defining the outcome and the covariates.
Description / Code source / CodesEndocarditis / ICD-9 / 421.0, 421.9, 424.9
Valve-related risk factors for endocarditis, including congenital disorders
Valvuloplasty / HCPCS / 33400, 33401, 33403,33425, 33426, 33427, 33463, 33464
ICD-9 / 35.96, 35.1, 35.10 – 35.14
Replacement / HCPCS / 33405, 33406, 33410 - 33413, 33430, 33465, 33475
ICD-9 / 35.06, 35.07, 35.08, 35.09, 35.2, 35.20, 35.21-35.28
Valvotomy / HCPCS / 33420, 33422, 33460, 33470, 33471, 33472, 33474
ICD-9 / 35.0, 35.00 - 35.05
Resection, repair / HCPCS / 33414-33417, 33468, 33476, 33478, 33496
ICD-9 / 35.97
Conduits / HCPCS / 33404
ICD-9 / 35.92-35.95
Diseases of mitral valve / ICD-9 / 394, 394.0, 394.1, 394.2, 394.9, 396.0-396.3, 396.8, 396.9, 424.0, 746.5, 746.6,
Diseases of aortic valve / ICD-9 / 395, 395.0, 395.1, 395.2, 395.9, 424.1, 746.3, 746.4
Diseases of tricuspid valve / 397, 397.0, 397.9, 424.2, 746.1, 746.2
Diseases of pulmonary valve / 397.1, 424.3, 746.0, 746.00, 746.01, 746.02, 746.09
Rheumatic fever with heart involvement / ICD-9 / 391, 391.1,
Structural heart risk factors for endocarditis other than valve-related
Septum-related / HCPCS / 33641, 33645, 33647, 33660, 33665, 33670, 33681, 33684, 33688,
ICD-9 / 35.4, 35.41, 35.42, 35.5, 35.50-35.55, 35.6, 35.60 – 35.63, 35.7, 35.70 – 35.73, 35.98
745.5, 745.6, 745.60, 745.61, 745.69, 745.7, 745.9
Sinus of Valsalva-related / HCPCS / 33702, 33710, 33720, 33722
ICD-9 / 35.39
Non-valvular congenital disorders / ICD-9 / 745.0, 745.1, 745.10-745.12, 745.19, 745.2, 745.3, 745.4, 745.8, 746.7, 746.81-746.84, 746.9
Intravascular devices
Pacemakers / HCPCS / 33206 - 33208, 33210, 33214 – 33218, 33220, 33222 – 33226, 33233 - 33235, 33238, 33240, 33241, 33243, 33244, 33249.
ICD-9 / 00.50, 00.51, 00.52, 00.54, 37.7, 37.70, 37.71, 37.72, 37.73, 37.75, 37.78, 37.8, 37.80 – 37.83, 37.85 – 37.87, 37.89
Peritoneal-venous shunt / HCPCS / 49425-49429
Ventriculo-atrial shunt / HCPCS / 62220
ICD-9 / 02.32
End stage renal disease / ICD-9 / 585.6
Dialysis-related procedures / HCPCS / 90921, 90925, 90935, 90937, 90940, 90945, 90947, 90989, 90993, 90997, 90999, 36800, 36810, 36815, 36818, 36819, 36820, 36821.
Venous catheterization for renal dialysis / ICD-9 / 38.95
Arteriovenostomy for renal dialysis / ICD-9 / 38.95, 39.42, 39.43
Hemodialysis / ICD-9 / 39.95
Peritoneal dialysis / ICD-9 / 54.98
Anemia / ICD-9 / 280.0, 280.1, 280.8, 280.9, 281.0, 281.8, 281.9, 285.1, 285.2, 285.9
Gastrointestinal bleeding / ICD-9 / 286.5, 459.0, 562.02, 562.03, 562.12, 562.13, 569.3, 569.84, 569.85, 569.86, 578.1, 578.9, 792.1, 998.11'
Gastrointestinal symptoms / ICD-9
Constipation / 564.0, 564.00, 564.09, 564.01, 564.02
Diarrhea / 008.42, 008.43, 008.45, 008.5, 008.8, 009.0, 009.1, 009.2, 009.3, 558.2, 558.3, 558.9, 564.4, 564.5, 564.8, 564.9, 787.91
Change in bowel habit / 787.99
Abdominal pain / 789.0, 787.3, 789.4, 789.6
Irritable bowel syndrome / 564.1
Large bowel obstruction / 560, 560.8, 560.9, 560.89
Treatments
Colon surgery / HCPCS / 44140, 44141, 44143, 44144, 44145, 44146, 44147, 44150, 44151, 44152, 44153, 44155, 44156, 44157, 44158, 44160, 44204, 44205, 44206, 44207, 44208, 44210, 44211, 44212
ICD-9 / 45.72, 45.73, 45.74, 45.75, 45.76, 45.8, 17.3, 17.31, 17.32, 17.33, 17.34, 17.35, 17.36, 17.37, 17.38, 17.39
Betos / P1B
Chemotherapy1 / HCPCS / J9000-J99992, Q0083-Q0085, J8520, J8521, J8530, J8540, J8560, J8597, J8610, J8999
ICD-9 / 9925, V581, V662, V672
Revenue center / 0331, 0332, 0335
Visits to the emergency department / HCPCS / 99281, 99282, 99283, 99284, 99285, 99291, 99292
Clinical evaluation3 / HCPCS / 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99221, 99222, 99223, 99231, 99232, 99233, 99234, 99235, 99236, 99241, 99242, 99243, 99244, 99245, 99251, 99252, 99253, 99254, 99255, 99261, 99262, 99263, 99271, 99272, 99273, 99274, 99275, 99301, 99302, 99303, 99311, 99312, 99313, 99361, 99362
1 To identify oral capecitabine in the DME file we used the following National Drug Codes: 00004110020, 00004110150, 00004110116, 00004110051, 00004110013, 00004110022, 00004110113, 00004110151.
2 Excluding the following codes from this sequence: J9003, J9165, J9175, J9202, J9209, J9212-J9226, J9240, J9295, J9381, J9395.
3 Clinical evaluation consists on any of the following: new outpatient, established outpatient, hospital observation services, new inpatient, established inpatient, observation/inpatient care services, outpatient consultation, inpatient consultation, follow-up inpatient consultation, confirmatory consultation, nursing facility services and team conference.
Table A2. Incidence rate of pyelonephritis and meningitis in between 90 days before and 90 days after the diagnosis of colorectal, lung, breast, and prostate cancer
Cases per 100,000 person-months (95% CI)Persons / Person-months / Cases / Crude rate / Standardized rate1
Colorectal
Pyelonephritis / 167,390 / 963,521 / 137 / 14.2 (11.8-16.6) / 14.2 (11.8-16.6)
Meningitis / 167,839 / 966,382 / * / 1.1 (0.5-1.8) / 1.1 (0.5-1.8)
Lung
Pyelonephritis / 208,702 / 1,159,817 / 158 / 13.6 (11.5-15.7) / 14.8 (12.1-17.5)
Meningitis / 209,207 / 1,162,863 / 24 / 2.1 (0.4-1.2) / 1.6 (0.9-2.3)
Breast
Pyelonephritis / 169,434 / 996,830 / 102 / 10.2 (8.2-12.2) / 10.2 (8.2-12.3)
Meningitis / 169,991 / 1,000,374 / * / 0.4 (0.0-0.8) / 0.4 (0.0-0.8)
Prostate
Pyelonephritis / 202,583 / 1,193,481 / 149 / 12.5 (10.5-14.4) / 15.7 (12.7-18.7)
Meningitis / 202,794 / 1,195,078 / * / 0.4 (0.1-0.8) / 0.4 (0.0-0.7)
Non-cancer
Pyelonephritis / 276,182 / 1,624,815 / 124 / 7.6 (6.3-9.0) / 7.6 (6.1-9.1)
Meningitis / 277,120 / 1,630,588 / 16 / 1.0 (0.5-1.5) / 0.9 (0.4-1.4)
1 Incidence rate is directly standardized to the age and sex (except for breast and prostate cancer) distribution of colorectal cancer cases.
* Cells with counts of 11 or lower are blinded following SEER-Medicare privacy policy
Table A3. Survival analysis using different time frames to define concomitant diagnosis of infective endocarditis and stage I-III colorectal cancer*
No endocarditis / EndocarditisEndocarditis between 60 days before and 60 days after cancer diagnosis
N / 139,631 / 142
2-year overall survival, % / 73.1 (72.8-73.3) / 49.5 (41.0-57.5)
2-year CRC-specific survival, % / 85.7 (85.5-85.9) / 85.5 (77.5-90.8)
HR overall survival / Reference / 1.60 (1.33-1.93)
HR CRC-specific survival / Reference / 1.30 (0.89-1.89)
Endocarditis between 120 days before and 120 days after cancer diagnosis
N / 139,583 / 190
2-year overall survival, % / 73.1 (72.8-73.3) / 48.1 (40.8-55.0)
2-year CRC-specific survival, % / 85.7 (85.5-85.9) / 85.0 (78.2-89.9)
HR overall survival / Reference / 1.62 (1.39-1.90)
HR CRC-specific survival / Reference / 1.28 (0.92-1.77)
*HR: hazard ratio, CRC: colorectal cancer
Figure A1. Relationship between diagnostic colonoscopy and admission due to infective endocarditis.
7