Azam Torabi
Influence of case definition on incidence and outcome of acute coronary syndromes
Torabi, Azam; Cleland, John G F; Sherwi, Nasser; Atkin, Paul; Panahi, Hossein; Kilpatrick, Eric; Thackray, Simon; Hoye, Angela; Alamgir, Farqad; Goode, Kevin; Clark, Andrew L; Rigby, Alan
Authors
John G F Cleland
Nasser Sherwi
Paul Atkin
Hossein Panahi
Eric Kilpatrick
Simon Thackray
Angela Hoye
Farqad Alamgir
Dr Kevin Goode K.M.Goode@hull.ac.uk
Research Systems Project Manager / Business Analyst
Andrew L Clark
Alan Rigby
Abstract
© 2016, BMJ Publishing Group. All rights reserved. Objective: Acute coronary syndromes (ACS) are common, but their incidence and outcome might depend greatly on how data are collected. We compared case ascertainment rates for ACS and myocardial infarction (MI) in a single institution using several different strategies. Methods: The Hull and East Yorkshire Hospitals serve a population of ∼560 000. Patients admitted with ACS to cardiology or general medical wards were identified prospectively by trained nurses during 2005. Patients with a death or discharge code of MI were also identified by the hospital information department and, independently, from Myocardial Infarction National Audit Project (MINAP) records. The hospital laboratory identified all patients with an elevated serum troponin-T (TnT) by contemporary criteria ( > 0.03 μg/L in 2005). Results: The prospective survey identified 1731 admissions (1439 patients) with ACS, including 764 admissions (704 patients) with MIs. The hospital information department reported only 552 admissions (544 patients) with MI and only 206 admissions (203 patients) were reported to the MINAP. Using all 3 strategies, 934 admissions (873 patients) for MI were identified, for which TnT was > 1 μg/L in 443, 0.04-1.0 μg/L in 435, =0.03 μg/L in 19 and not recorded in 37. A further 823 patients had TnT > 0.03 μg/L, but did not have ACS ascertained by any survey method. Of the 873 patients with MI, 146 (16.7%) died during admission and 218 (25.0%) by 1 year, but ranging from 9% for patients enrolled in the MINAP to 27% for those identified by the hospital information department. Conclusions: MINAP and hospital statistics grossly underestimated the incidence of MI managed by our hospital. The 1-year mortality was highly dependent on the method of ascertainment.
Citation
Torabi, A., Cleland, J. G. F., Sherwi, N., Atkin, P., Panahi, H., Kilpatrick, E., Thackray, S., Hoye, A., Alamgir, F., Goode, K., Clark, A. L., & Rigby, A. (2016). Influence of case definition on incidence and outcome of acute coronary syndromes. Open heart, 3(2), e000487. https://doi.org/10.1136/openhrt-2016-000487
Journal Article Type | Article |
---|---|
Acceptance Date | Oct 18, 2016 |
Online Publication Date | Dec 30, 2016 |
Publication Date | 2016-12 |
Deposit Date | Feb 21, 2017 |
Publicly Available Date | Feb 21, 2017 |
Journal | Open Heart |
Electronic ISSN | 2053-3624 |
Publisher | BMJ Publishing Group |
Peer Reviewed | Peer Reviewed |
Volume | 3 |
Issue | 2 |
Article Number | e000487 |
Pages | e000487 |
DOI | https://doi.org/10.1136/openhrt-2016-000487 |
Keywords | Myocardial infarction; Epidemiology |
Public URL | https://hull-repository.worktribe.com/output/448705 |
Publisher URL | http://openheart.bmj.com/content/openhrt/3/2/e000487.full.pdf |
Additional Information | This is a copy of an open access article published in Open Heart, 2016, v.2. |
Contract Date | Feb 21, 2017 |
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Copyright Statement
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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