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)
|
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: | Mangion, Dr Kenneth and McConnachie, Professor Alex and Berry, Professor Colin and Mccowan, Professor Colin 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 > School of Cardiovascular & Metabolic Health College of Medical Veterinary and Life Sciences > School of Health & 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