Response Letter: Neurological Disease Triggering Takotsubo Syndrome

We thank Dr. Finsterer and Dr. Bersano for their interest in our article. We agree that Takotsubo syndrome has been associated with a myriad of neurological conditions, both acute and chronic. Our primary aim was to describe the strength of associations with the most common acute neurological diseases. To this end, we utilized data from 2006 to 2014 from the National Inpatient Sample which is the largest all-payer medical sample in the USA. Dr. Finsterer and Dr. Bersano raise concerns regarding the choice of administrative billing code for our outcome of interest. The National Inpatient Sample included only International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes prior to October 1, 2015 [1]. Indeed, ICD-10-CM billing codes were not in effect prior to 2015. As we limited our search from 2006 to 2014, we would not have missed patients with the ICD-10-CM diagnosis code for Takotsubo cardiomyopathy. …