Dataset Information

Cross vascular risk for first and recurrent hospitalised atherothrombosis determined retrospectively from linked data.

ABSTRACT:

Objectives

To determine the sex-specific and age-specific risk ratios for the first-ever and recurrent hospitalisation for cerebrovascular, coronary and peripheral arterial disease in persons with other vascular history versus without other vascular history in Western Australia from 2005to 2007.

Design

Cross-sectional linkage study.

Setting

Hospitalised population in a representative Australian State.

Participants

All persons aged 34-85 years between 1 January 2005 and 31 December 2007 were hospitalised with a principal diagnosis of atherothrombosis.

Data sources

Person-linked file of statutory-collected administrative morbidity and mortality records.

Main outcome measures

Sex-specific and age-specific risk ratios for the first-ever and recurrent hospitalisations for symptomatic atherothrombosis of the brain, coronary and periphery using a 15-year look-back period lead to the determining of prior events.

Results

Over 3 years, 40 877 (66% men; 55% first-ever) were hospitalised for atherothrombosis. For each arterial territory, age-specific recurrent rates were higher than the corresponding first-ever rates, with the biggest difference seen in the youngest age groups. For all types of first-ever atherothrombosis, the rates were higher in those with other vascular history and the risk ratios declined with an advancing age (trend: all p<0.0001) and remained significantly >1 even for 75-84 years old. However, for recurrent events, the rates were marginally higher in those with other vascular history and no risk ratio age trend was apparent with several not significantly >1 (trend: all p>0.13).

Conclusions

This study of hospitalised atherothrombosis suggests first-events predominate and that the risk of further events in the same or other arterial territory is very high for all ages and both sexes, accentuating the necessity for an early and sustained active prevention.

SUBMITTER: Briffa TG

PROVIDER: S-EPMC3840350 | biostudies-literature | 2013 Nov

REPOSITORIES: biostudies-literature

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Publications

Cross vascular risk for first and recurrent hospitalised atherothrombosis determined retrospectively from linked data.

Briffa Tom G TG Nedkoff Lee J LJ Knuiman Matthew W MW Hankey Graeme J GJ Norman Paul E PE Hung Joseph J Thompson Peter L PL Hickling Siobhan S Bremner Alexandra A Sanfilippo Frank M FM

BMJ open 20131120 11

<h4>Objectives</h4>To determine the sex-specific and age-specific risk ratios for the first-ever and recurrent hospitalisation for cerebrovascular, coronary and peripheral arterial disease in persons with other vascular history versus without other vascular history in Western Australia from 2005to 2007.<h4>Design</h4>Cross-sectional linkage study.<h4>Setting</h4>Hospitalised population in a representative Australian State.<h4>Participants</h4>All persons aged 34-85 years between 1 January 2005 a ...[more]

PMID: 24259391

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Project description:IntroductionMultimorbidity is a complex and growing health challenge. There is no accepted "gold standard" multimorbidity measure for hospital resource planning, and few studies have compared measures in hospitalised patients.AimTo evaluate operationalisation of two multimorbidity measures in routine hospital episode data in NHS Grampian, Scotland.MethodsLinked hospital episode data (Scottish Morbidity Record (SMR)) for the years 2009-2016 were used. Adults admitted to hospital as a general/acute inpatient during 2014 were included. Conditions (ICD-10) were identified from general/acute (SMR01) and psychiatric (SMR04) admissions during the five years prior to first admission in 2014. Two count-based multimorbidity measures were used (Charlson Comorbidity Index and Tonelli et al.), and multimorbidity was defined as ≥2 conditions. Kappa statistics assessed agreement. The association between multimorbidity and length of stay, readmission and mortality was assessed using logistic and negative binomial regression as appropriate.ResultsIn 41,545 adults (median age 62 years, 52.6% female), multimorbidity prevalence was 15.1% (95% CI 14.8%, 15.5%) using Charlson and 27.4% (27.0%, 27.8%) using Tonelli - agreement 85.1% (Kappa 0.57). Multimorbidity prevalence, using both measures, increased with age. Multimorbidity was higher in males (16.5%) than females (13.9%) using the Charlson measure, but similar across genders when measured with Tonelli. After adjusting for covariates, multimorbidity remained associated with longer length of stay (Charlson IRR 1.1 (1.0, 1.2); Tonelli IRR 1.1 (1.0, 1.2)) and readmission (Charlson OR 2.1 (1.9, 2.2); Tonelli OR 2.1 (2.0, 2.2)). Multimorbidity had a stronger association with mortality when measured using Charlson (OR 2.7 (2.5, 2.9)), than using Tonelli (OR 1.8 (1.7, 2.0)).ConclusionsMultimorbidity measures operationalised in hospital episode data identified those at risk of poor outcomes and such operationalised tools will be useful for future multimorbidity research and use in secondary care data systems. Multimorbidity measures are not interchangeable, and the choice of measure should depend on the purpose.HighlightsOperationalisation of two count-based multimorbidity measures using linked electronic hospital episode data was evaluated (Charlson and Tonelli).First study to compare the Tonelli measure with another measure for investigating multimorbidity in hospitalised patients.Multimorbidity prevalence differed depending on measure used, but both multimorbidity measures identified those at risk of poor outcomes.Operationalised multimorbidity tools have uses for future multimorbidity research and use in secondary care data systems.Multimorbidity measures are not interchangeable, and choice of measure should depend on purpose.

Dataset Information

Cross vascular risk for first and recurrent hospitalised atherothrombosis determined retrospectively from linked data.

Objectives

Design

Setting

Participants

Data sources

Main outcome measures

Results

Conclusions

Publications

Cross vascular risk for first and recurrent hospitalised atherothrombosis determined retrospectively from linked data.

Similar Datasets

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