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Metastatic Tumour

Catherine Morgan, Roger T Webb, Mathew J Carr, Evangelos Kontopantelis, Carolyn A Chew-Graham, Nav Kapur, Darren M. Ashcroft

Type
Disease or Syndrome
ID
PH882
Version ID
1843
Data Sources
Valid event data range
01/01/2001 - 31/12/2014
Sex
Female, Male
Agreement Date
2018-10-15
Coding system
Read codes v2 ICD10 codes
Tags /Collections
ClinicalCodes Repository Phenotype Library

Definition

Background:

Self-harm is a major risk factor for suicide, with older adults (older than 65 years) having reportedly greater suicidal intent than any other age group. With the aging population rising and paucity of research focus in this age group, the extent of the problem of self-harm needs to be established. In a primary care cohort of older adults we aimed to investigate the incidence of self-harm, subsequent clinical management, prevalence of mental and physical diagnoses, and unnatural-cause mortality risk, including suicide.

Methods:

The UK Clinical Practice Research Datalink contains anonymised patient records from general practice that routinely capture clinical information pertaining to both primary and secondary care services. We identified 4124 adults aged 65 years and older with a self-harm episode ascertained from Read codes recorded during 2001–14. We calculated standardised incidence and in 2854 adults with at least 12 months follow-up examined the frequency of psychiatric referrals and prescription of psychotropic medication after self-harm. We estimated prevalence of mental and physical illness diagnoses before and after self-harm and, using Cox regression in a matched cohort, we examined cause-specific mortality risks.

Findings:

Overall incidence of self-harm in older adults aged 65 years and older was 4·1 per 10 000 person-years with stable gender-specific rates observed over the 13-year period. After self-harm, 335 (11·7%) of 2854 adults were referred to mental health services, 1692 (59·3%) were prescribed an antidepressant, and 336 (11·8%) were prescribed a tricyclic antidepressant (TCA). Having a diagnosed previous mental illness was twice as prevalent in the self-harm cohort as in the comparison cohort (prevalence ratio 2·10 [95% CI 2·03–2·17]) and with a previous physical health condition prevalence was 20% higher in the self-harm cohort compared to the comparison cohort (1·20 [1·17–1·23]). Adults from the self-harm cohort (n=2454) died from unnatural causes an estimated 20 times more frequently than the comparison cohort (n=48 921) during the first year. A markedly elevated risk of suicide (hazard ratio 145·4 [95% CI 53·9–392·3]) was observed in the self-harm cohort.

Interpretation:

Within primary care, we have identified a group of older adults at high risk from unnatural death, particularly within the first year of self-harm. We have highlighted a high frequency of prescription of TCAs, known to be potentially fatally toxic in overdose. We emphasise the need for early intervention, careful alternative prescribing, and increased support when older adults consult after an episode of self-harm and with other health conditions.

Publications

  • Catherine Morgan, Roger T Webb, Mathew J Carr, Evangelos Kontopantelis, Carolyn A Chew-Graham, Nav Kapur, Darren M. Ashcroft, Self-harm in a primary care cohort of older people incidence, clinical management, and risk of suicide and other causes of death. Psychiatry, 5, 2018.

Clinical Code List

Rows: 137
Code Description Entity type Coding System (ICD-10 Read) Category
B153.00 Secondary malignant neoplasm of liver res69: metastatic_tumour Read diagnostic
B56..00 Secondary and unspecified malignant neoplasm of lymph nodes res69: metastatic_tumour Read diagnostic
B56..11 Lymph node metastases res69: metastatic_tumour Read diagnostic
B560.00 Secondary and unspec malig neop lymph nodes head/face/neck res69: metastatic_tumour Read diagnostic
B560000 Secondary and unspec malig neop of superficial parotid LN res69: metastatic_tumour Read diagnostic
B560100 Secondary and unspec malignant neoplasm mastoid lymph nodes res69: metastatic_tumour Read diagnostic
B560200 Secondary and unspec malig neop superficial cervical LN res69: metastatic_tumour Read diagnostic
B560300 Secondary and unspec malignant neoplasm occipital lymph node res69: metastatic_tumour Read diagnostic
B560400 Secondary and unspec malig neop deep parotid lymph nodes res69: metastatic_tumour Read diagnostic
B560500 Secondary and unspec malig neop submandibular lymph nodes res69: metastatic_tumour Read diagnostic
B560600 Secondary and unspec malig neop of facial lymph nodes res69: metastatic_tumour Read diagnostic
B560700 Secondary and unspec malig neop submental lymph nodes res69: metastatic_tumour Read diagnostic
B560800 Secondary and unspec malig neop anterior cervical LN res69: metastatic_tumour Read diagnostic
B560900 Secondary and unspec malig neop deep cervical LN res69: metastatic_tumour Read diagnostic
B560z00 Secondary unspec malig neop lymph nodes head/face/neck NOS res69: metastatic_tumour Read diagnostic
B561.00 Secondary and unspec malig neop intrathoracic lymph nodes res69: metastatic_tumour Read diagnostic
B561000 Secondary and unspec malig neop internal mammary lymph nodes res69: metastatic_tumour Read diagnostic
B561100 Secondary and unspec malig neop intercostal lymph nodes res69: metastatic_tumour Read diagnostic
B561200 Secondary and unspec malig neop diaphragmatic lymph nodes res69: metastatic_tumour Read diagnostic
B561300 Secondary and unspec malig neop ant mediastinal lymph nodes res69: metastatic_tumour Read diagnostic
B561400 Secondary and unspec malig neop post mediastinal lymph nodes res69: metastatic_tumour Read diagnostic
B561500 Secondary and unspec malig neop paratracheal lymph nodes res69: metastatic_tumour Read diagnostic
B561600 Secondary and unspec malig neop superfic tracheobronchial LN res69: metastatic_tumour Read diagnostic
B561700 Secondary and unspec malig neop inferior tracheobronchial LN res69: metastatic_tumour Read diagnostic
B561800 Secondary and unspec malig neop bronchopulmonary lymph nodes res69: metastatic_tumour Read diagnostic
B561900 Secondary and unspec malig neop pulmonary lymph nodes res69: metastatic_tumour Read diagnostic
B561z00 Secondary and unspec malig neop intrathoracic LN NOS res69: metastatic_tumour Read diagnostic
B562.00 Secondary and unspec malig neop intra-abdominal lymph nodes res69: metastatic_tumour Read diagnostic
B562000 Secondary and unspec malig neop coeliac lymph nodes res69: metastatic_tumour Read diagnostic
B562100 Secondary and unspec malig neop superficial mesenteric LN res69: metastatic_tumour Read diagnostic
B562200 Secondary and unspec malig neop inferior mesenteric LN res69: metastatic_tumour Read diagnostic
B562300 Secondary and unspec malig neop common iliac lymph nodes res69: metastatic_tumour Read diagnostic
B562400 Secondary and unspec malig neop external iliac lymph nodes res69: metastatic_tumour Read diagnostic
B562z00 Secondary and unspec malig neop intra-abdominal LN NOS res69: metastatic_tumour Read diagnostic
B563.00 Secondary and unspec malig neop axilla and upper limb LN res69: metastatic_tumour Read diagnostic
B563000 Secondary and unspec malig neop axillary lymph nodes res69: metastatic_tumour Read diagnostic
B563100 Secondary and unspec malig neop supratrochlear lymph nodes res69: metastatic_tumour Read diagnostic
B563200 Secondary and unspec malig neop infraclavicular lymph nodes res69: metastatic_tumour Read diagnostic
B563300 Secondary and unspec malig neop pectoral lymph nodes res69: metastatic_tumour Read diagnostic
B563z00 Secondary and unspec malig neop axilla and upper limb LN NOS res69: metastatic_tumour Read diagnostic
B564.00 Secondary and unspec malig neop inguinal and lower limb LN res69: metastatic_tumour Read diagnostic
B564000 Secondary and unspec malig neop superficial inguinal LN res69: metastatic_tumour Read diagnostic
B564100 Secondary and unspec malig neop deep inguinal lymph nodes res69: metastatic_tumour Read diagnostic
B564z00 Secondary and unspec malig neop of inguinal and leg LN NOS res69: metastatic_tumour Read diagnostic
B565.00 Secondary and unspec malig neop intrapelvic lymph nodes res69: metastatic_tumour Read diagnostic
B565000 Secondary and unspec malig neop internal iliac lymph nodes res69: metastatic_tumour Read diagnostic
B565200 Secondary and unspec malig neop circumflex iliac LN res69: metastatic_tumour Read diagnostic
B565300 Secondary and unspec malig neop sacral lymph nodes res69: metastatic_tumour Read diagnostic
B565z00 Secondary and unspec malig neop intrapelvic LN NOS res69: metastatic_tumour Read diagnostic
B56y.00 Secondary and unspec malig neop lymph nodes multiple sites res69: metastatic_tumour Read diagnostic
B56z.00 Secondary and unspec malig neop lymph nodes NOS res69: metastatic_tumour Read diagnostic
B57..00 Secondary malig neop of respiratory and digestive systems res69: metastatic_tumour Read diagnostic
B57..11 Metastases of respiratory and/or digestive systems res69: metastatic_tumour Read diagnostic
B57..12 Secondary carcinoma of respiratory and/or digestive systems res69: metastatic_tumour Read diagnostic
B570.00 Secondary malignant neoplasm of lung res69: metastatic_tumour Read diagnostic
B571.00 Secondary malignant neoplasm of mediastinum res69: metastatic_tumour Read diagnostic
B572.00 Secondary malignant neoplasm of pleura res69: metastatic_tumour Read diagnostic
B573.00 Secondary malignant neoplasm of other respiratory organs res69: metastatic_tumour Read diagnostic
B574.00 Secondary malignant neoplasm of small intestine and duodenum res69: metastatic_tumour Read diagnostic
B574000 Secondary malignant neoplasm of duodenum res69: metastatic_tumour Read diagnostic
B574200 Secondary malignant neoplasm of ileum res69: metastatic_tumour Read diagnostic
B574z00 Secondary malig neop of small intestine or duodenum NOS res69: metastatic_tumour Read diagnostic
B575.00 Secondary malignant neoplasm of large intestine and rectum res69: metastatic_tumour Read diagnostic
B575000 Secondary malignant neoplasm of colon res69: metastatic_tumour Read diagnostic
B575100 Secondary malignant neoplasm of rectum res69: metastatic_tumour Read diagnostic
B575z00 Secondary malig neop of large intestine or rectum NOS res69: metastatic_tumour Read diagnostic
B576.00 Secondary malig neop of retroperitoneum and peritoneum res69: metastatic_tumour Read diagnostic
B576000 Secondary malignant neoplasm of retroperitoneum res69: metastatic_tumour Read diagnostic
B576100 Secondary malignant neoplasm of peritoneum res69: metastatic_tumour Read diagnostic
B576200 Malignant ascites res69: metastatic_tumour Read diagnostic
B576z00 Secondary malig neop of retroperitoneum or peritoneum NOS res69: metastatic_tumour Read diagnostic
B577.00 Secondary malignant neoplasm of liver res69: metastatic_tumour Read diagnostic
B577.11 Liver metastases res69: metastatic_tumour Read diagnostic
B57y.00 Secondary malignant neoplasm of other digestive organ res69: metastatic_tumour Read diagnostic
B57z.00 Secondary malig neop of respiratory or digestive system NOS res69: metastatic_tumour Read diagnostic
B58..00 Secondary malignant neoplasm of other specified sites res69: metastatic_tumour Read diagnostic
B58..11 Secondary carcinoma of other specified sites res69: metastatic_tumour Read diagnostic
B580.00 Secondary malignant neoplasm of kidney res69: metastatic_tumour Read diagnostic
B581.00 Secondary malignant neoplasm of other urinary organs res69: metastatic_tumour Read diagnostic
B581000 Secondary malignant neoplasm of ureter res69: metastatic_tumour Read diagnostic
B581100 Secondary malignant neoplasm of bladder res69: metastatic_tumour Read diagnostic
B581200 Secondary malignant neoplasm of urethra res69: metastatic_tumour Read diagnostic
B581z00 Secondary malignant neoplasm of other urinary organ NOS res69: metastatic_tumour Read diagnostic
B582.00 Secondary malignant neoplasm of skin res69: metastatic_tumour Read diagnostic
B582000 Secondary malignant neoplasm of skin of head res69: metastatic_tumour Read diagnostic
B582100 Secondary malignant neoplasm of skin of face res69: metastatic_tumour Read diagnostic
B582200 Secondary malignant neoplasm of skin of neck res69: metastatic_tumour Read diagnostic
B582300 Secondary malignant neoplasm of skin of trunk res69: metastatic_tumour Read diagnostic
B582400 Secondary malignant neoplasm of skin of shoulder and arm res69: metastatic_tumour Read diagnostic
B582500 Secondary malignant neoplasm of skin of hip and leg res69: metastatic_tumour Read diagnostic
B582600 Secondary malignant neoplasm of skin of breast res69: metastatic_tumour Read diagnostic
B582z00 Secondary malignant neoplasm of skin NOS res69: metastatic_tumour Read diagnostic
B583.00 Secondary malignant neoplasm of brain and spinal cord res69: metastatic_tumour Read diagnostic
B583000 Secondary malignant neoplasm of brain res69: metastatic_tumour Read diagnostic
B583100 Secondary malignant neoplasm of spinal cord res69: metastatic_tumour Read diagnostic
B583200 Cerebral metastasis res69: metastatic_tumour Read diagnostic
B583z00 Secondary malignant neoplasm of brain or spinal cord NOS res69: metastatic_tumour Read diagnostic
B584.00 Secondary malignant neoplasm of other part of nervous system res69: metastatic_tumour Read diagnostic
B585.00 Secondary malignant neoplasm of bone and bone marrow res69: metastatic_tumour Read diagnostic
B585000 Pathological fracture due to metastatic bone disease res69: metastatic_tumour Read diagnostic
B586.00 Secondary malignant neoplasm of ovary res69: metastatic_tumour Read diagnostic
B587.00 Secondary malignant neoplasm of adrenal gland res69: metastatic_tumour Read diagnostic
B58y.00 Secondary malignant neoplasm of other specified sites res69: metastatic_tumour Read diagnostic
B58y000 Secondary malignant neoplasm of breast res69: metastatic_tumour Read diagnostic
B58y100 Secondary malignant neoplasm of uterus res69: metastatic_tumour Read diagnostic
B58y200 Secondary malignant neoplasm of cervix uteri res69: metastatic_tumour Read diagnostic
B58y211 Secondary cancer of the cervix res69: metastatic_tumour Read diagnostic
B58y300 Secondary malignant neoplasm of vagina res69: metastatic_tumour Read diagnostic
B58y400 Secondary malignant neoplasm of vulva res69: metastatic_tumour Read diagnostic
B58y411 Secondary cancer of the vulva res69: metastatic_tumour Read diagnostic
B58y500 Secondary malignant neoplasm of prostate res69: metastatic_tumour Read diagnostic
B58y600 Secondary malignant neoplasm of testis res69: metastatic_tumour Read diagnostic
B58y700 Secondary malignant neoplasm of penis res69: metastatic_tumour Read diagnostic
B58y800 Secondary malignant neoplasm of epididymis and vas deferens res69: metastatic_tumour Read diagnostic
B58y900 Secondary malignant neoplasm of tongue res69: metastatic_tumour Read diagnostic
B58yz00 Secondary malignant neoplasm of other specified site NOS res69: metastatic_tumour Read diagnostic
B58z.00 Secondary malignant neoplasm of other specified site NOS res69: metastatic_tumour Read diagnostic
B59..00 Malignant neoplasm of unspecified site res69: metastatic_tumour Read diagnostic
B590.00 Disseminated malignancy NOS res69: metastatic_tumour Read diagnostic
B590.11 Carcinomatosis res69: metastatic_tumour Read diagnostic
B591.00 Other malignant neoplasm NOS res69: metastatic_tumour Read diagnostic
B592.00 Malignant neoplasms of independent (primary) multiple sites res69: metastatic_tumour Read diagnostic
B592X00 Kaposi's sarcoma of multiple organs res69: metastatic_tumour Read diagnostic
B593.00 Primary malignant neoplasm of unknown site res69: metastatic_tumour Read diagnostic
B594.00 Secondary malignant neoplasm of unknown site res69: metastatic_tumour Read diagnostic
B59z.00 Malignant neoplasm of unspecified site NOS res69: metastatic_tumour Read diagnostic
B5y..00 Malignant neoplasm of other and unspecified site OS res69: metastatic_tumour Read diagnostic
B5z..00 Malignant neoplasm of other and unspecified site NOS res69: metastatic_tumour Read diagnostic
ByuC.00 [X]Malignant neoplasm of ill-defined, secondary and unspeci res69: metastatic_tumour Read diagnostic
ByuC100 [X]Malignant neoplasm/overlap lesion/other+ill-defined sites res69: metastatic_tumour Read diagnostic
ByuC200 [X]2ndry+unspcf malignant neoplasm lymph nodes/multi regions res69: metastatic_tumour Read diagnostic
ByuC300 [X]Secondary malignant neoplasm/oth+unspc respiratory organs res69: metastatic_tumour Read diagnostic
ByuC400 [X]Secondary malignant neoplasm/oth+unspcfd digestive organs res69: metastatic_tumour Read diagnostic
ByuC500 [X]2ndry malignant neoplasm/bladder+oth+unsp urinary organs res69: metastatic_tumour Read diagnostic
ByuC600 [X]2ndry malignant neoplasm/oth+unspec parts/nervous system res69: metastatic_tumour Read diagnostic
ByuC700 [X]Secondary malignant neoplasm of other specified sites res69: metastatic_tumour Read diagnostic
ByuC800 [X]Malignant neoplasm without specification of site res69: metastatic_tumour Read diagnostic
Rows: 1
Code Description Entity type Coding System (ICD-10 Read) Category
C76-C80 Malignant neoplasms of ill-defined, secondary and unspecified sites res69: metastatic_tumour ICD-10 diagnostic

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH882/version/1843/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH882/version/1843/detail/?format=json
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get details of phenotype

details = get_phenotype_detail_by_version('PH882', '1843', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH882/version/1843/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH882/version/1843/export/codes/?format=json
CSV site_root/phenotypes/PH882/version/1843/export/codes/
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get codelists of phenotype

codelists = get_phenotype_code_list('PH882', '1843', api_client=client)

Version History

Version
ID
Name Owner Publish date
1843 Metastatic Tumour ieuan.scanlon 2022-04-04 currently shown

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