Assessment of Vital Status in Department of Veterans Affairs National Databases

Dominitz, Jason A.; Maynard, Charles; Boyko, Edward J.

doi:10.1016/s1047-2797(01)00211-3

Cited by 67 publications

(45 citation statements)

References 12 publications

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“…The BIRLS death file has been shown to have a 94.5% ascertainment of death, which compares favorably with that of the National Death Index (96.7%) (30,31). Dates of death were collected from 1 October 1997 until 31 March 1999.…”

Section: Discussionmentioning

confidence: 99%

Racial Differences in Diabetic Nephropathy, Cardiovascular Disease, and Mortality in a National Population of Veterans

2003

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OBJECTIVE—To determine racial differences in the prevalence of diabetic nephropathy, cardiovascular disease (CVD), and risk of mortality in a national health care system. RESEARCH DESIGN AND METHODS—A longitudinal cohort study was conducted in 429,918 veterans with diabetes. Racial minority groups were analyzed for baseline differences in prevalence of early diabetic nephropathy, diabetic end-stage renal disease (ESRD) and CVD, and longitudinal risk of mortality compared with Caucasians. RESULTS—The 429,918 patients identified with diabetes were of the following racial groups: Caucasian (56.2%), African American (15.3%), Asian (0.5%), Native American (0.4%), and unknown race (21.4%). Minority individuals were, on average, younger and less likely to have CVD but were more likely to have renal disease than Caucasians. After adjustment for age, sex, and economic status, African Americans (adjusted odds ratio [OR] = 1.3, 95% CI 1.2–1.4) and Native Americans (1.5, 1.1–2.1) were more likely to have early diabetic nephropathy than Caucasians. Diabetic ESRD was more likely to be present in African Americans (1.9, 1.9–2.0), Hispanics (1.4, 1.3–1.4), Asians (1.8, 1.5–2.1), and Native Americans (1.9, 1.5–2.3) than Caucasians. Concurrently, the adjusted OR of CVD in racial minority groups was 27–49% less than in Caucasians, whereas the 18-month risk of mortality among people from most racial minority groups was 7–12% lower than in Caucasians. CONCLUSIONS—We conclude that when access to care is comparable, microvascular complications, macrovascular disease, and subsequent death occur with different frequencies among various racial groups.

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Section: Discussionmentioning

confidence: 99%

Racial Differences in Diabetic Nephropathy, Cardiovascular Disease, and Mortality in a National Population of Veterans

2003

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“…The Vital Status File was used to obtain dates of death of patients after hospital discharge; the validity of this file, with respect to the National Death Index, has been previously demonstrated. 21,22 Each of the databases includes unique identifiers that allow merging of patient-level information across the databases.…”

Section: Data Sourcesmentioning

confidence: 99%

Psychiatric Comorbidity and Mortality After Acute Myocardial Infarction

Abrams

Vaughan-Sarrazin

Rosenthal

2009

Circ: Cardiovascular Quality and Outcomes

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Background-Prior studies of the impact of psychiatric comorbidity on outcomes after acute myocardial infarction (AMI) have frequently relied on inpatient secondary diagnosis codes. This study compared associations between psychiatric comorbidity and AMI outcomes that were derived using secondary diagnosis codes and codes captured from prior outpatient encounters. Methods and Results-Retrospective cohort study analyzing 21 745 patients admitted in 2004 to 2006 to Veterans Health Administration hospitals with AMI using administrative data. Psychiatric comorbidity was identified using (1) secondary inpatient diagnosis codes from the index hospitalization and (2)

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“…The ACC is the repository for information on all hospitalizations and outpatient visits that occur within VA health care systems nationally. (23,24).…”

Section: Subjects and Settingmentioning

confidence: 99%

Effects of Ethnicity and Nephropathy on Lower-Extremity Amputation Risk Among Diabetic Veterans

et al. 2003

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OBJECTIVE -To describe ethnic differences in the risk of amputation in diabetic patients with diabetic nephropathy. RESEARCH DESIGN AND METHODS-A retrospective cohort study was conducted on a national cohort of diabetic patients who received primary care within the Veterans Affairs (VA) Health Care System. Hospitalizations for lower-limb amputations were established by ICD-9-CM procedure codes. Relative risk of amputation in diabetic patients with and without diabetic nephropathy was determined using Cox proportional hazard modeling for unadjusted and adjusted models.RESULTS -Of the 429,918 subjects identified with diabetes (mean age 64 Ϯ 11 years, 97.4% male), 3,289 individuals were determined to have had a lower-limb amputation during the study period. Compared with diabetic patients without amputations, amputees were on average older, more likely to belong to a minority group, and were more likely to have received treatment for more comorbid conditions. Asians were more likely to have toe amputations compared with whites or other ethnicities, while Native Americans were more likely to have below-the-knee amputations. Native Americans had the highest risk of amputation (RR 1.74, 95% CI 1.39 -2.18), followed by African Americans (RR 1.41, 95% CI 1.34 -1.48) and Hispanics (RR 1.28, 95% CI 1.20 -1.38) compared with whites. The presence of diabetic nephropathy increased the risk of amputation threefold in all groups. Asian subjects with diabetes had the lowest adjusted relative risk of amputation (RR 0.31, 95% CI 0.19 -0.50).CONCLUSIONS -Among diabetic patients, certain ethnic minority individuals have an increased risk of lower-extremity amputation compared with whites. Presence of diabetic nephropathy further increases this risk. Diabetes Care 26:495-501, 2003

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Assessment of Vital Status in Department of Veterans Affairs National Databases

Cited by 67 publications

References 12 publications

Racial Differences in Diabetic Nephropathy, Cardiovascular Disease, and Mortality in a National Population of Veterans

Racial Differences in Diabetic Nephropathy, Cardiovascular Disease, and Mortality in a National Population of Veterans

Psychiatric Comorbidity and Mortality After Acute Myocardial Infarction

Effects of Ethnicity and Nephropathy on Lower-Extremity Amputation Risk Among Diabetic Veterans

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