Linking hospital patient records for suspected or established acute coronary syndrome in a complex secondary care system: a proof-of-concept e-registry in NHS Scotland

Findlay, I., Morris, T., Zhang, R. , Mccowan, C. , Shield, S., Forbes, B., McConnachie, A. , Mangion, K. and Berry, C. (2018) Linking hospital patient records for suspected or established acute coronary syndrome in a complex secondary care system: a proof-of-concept e-registry in NHS Scotland. European Heart Journal: Quality of Care and Clinical Outcomes, 4(3), pp. 155-167. (doi:10.1093/ehjqcco/qcy007) (PMID:29462281) (PMCID:PMC6030982)

[img]
Preview
Text
157661.pdf - Published Version
Available under License Creative Commons Attribution.

514kB

Abstract

Aims: To implement secondary care electronic record linkage for patients hospitalised with suspected or known acute coronary syndrome (ACS) in a complex regional healthcare system and evaluate this e-Registry in terms of patterns of service delivery and 1-year outcomes. Methods and Results: Existing electronic hospital records were linked to create episodes of care using (1) a patient administration system, (2) invasive cardiovascular procedure referrals and (3) a catheter laboratory record. Data were extracted for admissions (1 October 2013 – 30 September 2014) with ICD-10 diagnosis of angina (I200-I209), myocardial infarction (I210-I229), other ischaemic heart disease (I240-I249) or heart failure (I50), linked to other sources to develop a secondary care ACS e-registry and analysed within a Safe Haven. Episodes of care were categorised into care pathways and evaluated in terms of patient characteristics, as well as service delivery metrics and outcomes including mortality. 2327 patients had 2472 episodes of care. Diagnoses were hierarchically classified as STEMI (586, 25.2%), NSTEMI (1068, 45.9%), unspecified MI (146, 6.3%), unstable angina (527, 22.6%) for the first hospitalisation for each patient within the study period. Six care pathways were mapped. Percutaneous coronary intervention rate for STEMI was 80.2% and for NSTEMI 33.1%. Unadjusted all-cause mortality was 9.0% and 3.0% for STEMI and NSTEMI at 30 days, rising to 11.9% and 11.6% at 1 year. Analyses were validated by independent source data verification. Conclusion: The e-registry has enabled analysis of ACS hospitalisations in a complex healthcare system with implications for quality improvement and research.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Berry, Professor Colin and McConnachie, Dr Alex and Mccowan, Professor Colin and Mangion, Dr Kenneth and Zhang, Miss Rui Qi
Authors: Findlay, I., Morris, T., Zhang, R., Mccowan, C., Shield, S., Forbes, B., McConnachie, A., Mangion, K., and Berry, C.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:European Heart Journal: Quality of Care and Clinical Outcomes
Publisher:Oxford University Press
ISSN:2058-5225
ISSN (Online):2058-1742
Published Online:16 February 2018
Copyright Holders:Copyright © 2018 The Authors
First Published:First published in European Heart Journal: Quality of Care and Clinical Outcomes 4(3): 155-167
Publisher Policy:Reproduced in accordance with the publisher copyright policy

University Staff: Request a correction | Enlighten Editors: Update this record

Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
699321Myocardial strain measurements in survivors of acute ST-elevation myocardial infarction: implementation and prognostic significance of novel magnetic resonance imaging methods.Colin BerryBritish Heart Foundation (BHF)FS/15/54/31639RI CARDIOVASCULAR & MEDICAL SCIENCES