Rapsomaniki, E;
Thuresson, M;
Yang, E;
Blin, P;
Hunt, P;
Chung, S-C;
Stogiannis, D;
... Hemingway, H; + view all
(2016)
Using big data from health records from four countries to evaluate chronic disease outcomes: a study in 114 364 survivors of myocardial infarction.
European Heart Journal - Quality of Care and Clinical Outcomes
, 2
(3)
pp. 172-183.
10.1093/ehjqcco/qcw004.
Preview |
Text
ehjqcco.qcw004.full.pdf - Published Version Download (920kB) | Preview |
Abstract
AIMS: To assess the international validity of using hospital record data to compare long-term outcomes in heart attack survivors. METHODS: and results We used samples of national, ongoing, unselected record sources to assess three outcomes: cause death; a composite of myocardial infarction (MI), stroke, and all-cause death; and hospitalized bleeding. Patients aged 65 years and older entered the study 1 year following the most recent discharge for acute MI in 2002–11 [n = 54 841 (Sweden), 53 909 (USA), 4653 (England), and 961 (France)]. Across each of the four countries, we found consistent associations with 12 baseline prognostic factors and each of the three outcomes. In each country, we observed high 3-year crude cumulative risks of all-cause death (from 19.6% [England] to 30.2% [USA]); the composite of MI, stroke, or death [from 26.0% (France) to 36.2% (USA)]; and hospitalized bleeding [from 3.1% (France) to 5.3% (USA)]. After adjustments for baseline risk factors, risks were similar across all countries [relative risks (RRs) compared with Sweden not statistically significant], but higher in the USA for all-cause death [RR USA vs. Sweden, 1.14 (95% confidence interval 1.04–1.26)] and hospitalized bleeding [RR USA vs. Sweden, 1.54 (1.21–1.96)]. CONCLUSION: The validity of using hospital record data is supported by the consistency of estimates across four countries of a high adjusted risk of death, further MI, and stroke in the chronic phase after MI. The possibility that adjusted risks of mortality and bleeding are higher in the USA warrants further study.
| Type: | Article |
|---|---|
| Title: | Using big data from health records from four countries to evaluate chronic disease outcomes: a study in 114 364 survivors of myocardial infarction |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1093/ehjqcco/qcw004 |
| Publisher version: | http://dx.doi.org/10.1093/ehjqcco/qcw004 |
| Language: | English |
| Additional information: | Copyright © The Author 2016. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
| Keywords: | Acute myocardial infarction, Co-morbidities, Healthcare systems, International comparison, Long-term outcomes, EHR |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics > Clinical Epidemiology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1493456 |
Archive Staff Only
 |
View Item |
