Identifying Patients with Physician‐Diagnosed Asthma in Health Administrative Databases

Gershon, Andrea S.; Wang, Chengning; Guan, Jun; Vasilevska-Ristovska, Jovanka; Cicutto, Lisa; To, Teresa

doi:10.1155/2009/963098

Cited by 353 publications

(312 citation statements)

References 11 publications

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“…Comorbidities were identified from the CorHealth Ontario registry and supplemented with data from the Discharge Abstract Database, the Same Day Surgery database, and the Ontario Health Insurance Plan database using International Classification of Diseases, Tenth Revision, Canada ( ICD‐10‐CA ) codes32 within 5 years before CABG using validated algorithms 18, 20, 33, 34, 35. We estimated socioeconomic status on the basis of patients’ neighborhood median income in the Canadian census and determined their residence (rural versus urban) using Statistics Canada definitions 36.…”

Section: Methodsmentioning

confidence: 99%

Association of Frailty and Long‐Term Survival in Patients Undergoing Coronary Artery Bypass Grafting

Tran

Dupuis

et al. 2018

JAHA

104

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BackgroundFrailty is increasing in prevalence and poses a formidable challenge for clinicians. The cardiac surgery literature consists primarily of small single‐center studies with limited follow‐up, and the epidemiological features of frailty remain to be elucidated in long‐term follow‐up.Methods and ResultsWe conducted a population‐based, retrospective, cohort study in Ontario, Canada, between 2008 and 2015. Frailty was defined using the Johns Hopkins Adjusted Clinical Groups frailty indicator (a multidimensional instrument validated for research using administrative data). The primary outcome was mortality. Mortality rates were calculated using the Kaplan‐Meier method. The hazard of death was assessed using a multivariable Cox proportional hazard model. Of 40 083 patients, 8803 (22%) were frail. At 4±2 years of follow‐up, age‐ and sex‐standardized mortality rate per 1000 person‐years was higher in frail (33; 95% confidence interval, 29–36) compared with nonfrail (22; 95% confidence interval, 19–24) patients. Frailty was associated with an increased risk of long‐term mortality (adjusted hazard ratio, 1.20; 95% confidence interval, 1.12–1.28) and greater differences in the survival of patients between 40 and 74 years of age than in those who were ≥85 years old.ConclusionsFrailty was present in a large proportion of patients undergoing coronary artery bypass grafting and was independently associated with long‐term mortality. The adjusted risk of frailty‐related death was inversely proportional to age. Our findings highlight the need for more comprehensive preoperative risk stratification models to assist with optimal selection of operative candidates. In addition, we identified the <75 years age group as a potential target for comprehensive preoperative optimization programs, such as cardiac prehabilitation, nutritional augmentation, and psychosocial support.

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Section: Methodsmentioning

confidence: 99%

Association of Frailty and Long‐Term Survival in Patients Undergoing Coronary Artery Bypass Grafting

Tran

Dupuis

et al. 2018

JAHA

104

View full text Add to dashboard Cite

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“…Comorbidities were identified from the CorHealth Ontario registry and supplemented with data from DAD, SDS, and OHIP using International Classification of Diseases––10th Revision (ICD‐10) codes19 within 5 years before CABG and using validated algorithms (eg, chronic obstructive pulmonary disease [COPD], asthma, hypertension, diabetes mellitus) 15, 17, 20, 21. We estimated socioeconomic status based on patients’ neighborhood median income in the Canadian census and determined their residence (rural versus urban) using Statistics Canada definitions 22.…”

Section: Methodsmentioning

confidence: 99%

Prevalence and Long‐Term Survival After Coronary Artery Bypass Grafting in Women and Men With Heart Failure and Preserved Versus Reduced Ejection Fraction

Sun

Eddeen

2018

JAHA

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BackgroundHeart failure (HF) with reduced ejection fraction (rEF) is a widely regarded prognosticator after coronary artery bypass grafting. HF with preserved ejection fraction (pEF) accounts for up to half of all HF cases and is associated with considerable morbidity and mortality in hospitalized cohorts. However, HFpEF outcomes have not been elucidated in cardiac surgical patients. We investigated the prevalence and outcomes of HFpEF and HFrEF in women and men following coronary artery bypass grafting.Methods and ResultsWe conducted a retrospective cohort study in Ontario, Canada, between October 1, 2008, and March 31, 2015, using Cardiac Care Network and Canadian Institute of Health Information data. HF is captured through a validated population‐based database of all Ontarians with physician‐diagnosed HF. We defined pEF as ejection fraction ≥50% and rEF as ejection fraction <50%. The primary outcome was all‐cause mortality. Analyses were stratified by sex. Mortality rates were calculated using Kaplan–Meier method. The relative hazard of death was assessed using multivariable Cox proportional hazard models. Of 40 083 patients (20.6% women), 55.5% had pEF without HF, 25.7% had rEF without HF, 6.9% had HFpEF, and 12.0% had HFrEF. Age‐standardized HFpEF mortality rates at 4±2 years of follow‐up were similar in women and men. HFrEF standardized HFpEF mortality rates were higher in women than men.ConclusionsWe found a higher prevalence and poorer prognosis of HFpEF in women. A history of HF was a more important prognosticator than ejection fraction. Preoperative screening and extended postoperative follow‐up should be focused on women and men with HF rather than on rEF alone.

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“…Validated algorithms were used to determine if patients had congestive heart failure, 33 hypertension, 34 a history of acute coronary syndromes, 35 diabetes mellitus, 36 asthma, 37 or chronic obstructive pulmonary disease. 38 Previously described methods were used to identify the following comorbidities based on ICD-9 and ICD-10 codes from the DAD in the two years preceding surgery 39 : atrial fibrillation or flutter; dementia; hemiplegia or hemiparesis; cerebrovascular disease; primary (excluding non-melanoma skin cancer) malignancy; metastatic tumours; peripheral vascular disease; renal disease; dialysis; liver disease; peptic ulcer disease; rheumatologic disease; and venous thromboembolism.…”

Section: Covariatesmentioning

confidence: 99%

Impact of ambulatory surgery day of the week on postoperative outcomes: a population-based cohort study

McIsaac

Bryson

Walraven

2015

Can J Anesth/J Can Anesth

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Purpose Ambulatory surgery is generally considered safe; however, as many as 3% of patients require unplanned acute postoperative care. The purpose of this study was to measure the impact of the day of the week of surgery on the outcomes of ambulatory surgery. Methods Using population-based health administrative data, we conducted a historical cohort analysis by identifying patients who underwent ambulatory surgery from 2002-2012. Multivariable regression was used to measure the association between the day of the week of surgery and the primary outcomes of 30-day emergency department (ED) visit or hospital readmission after successful discharge on the day of surgery. The secondary outcome that was similarly compared was unsuccessful discharge on the day of surgery. Results Of 296,497 patients identified, 32,100 (10.5%) returned to the ED or were readmitted to hospital within 30 days. Adjusting for demographics, comorbidities, and preoperative use of health resources, Friday surgery was most associated with the primary outcome (adjusted hazard ratio, 1.07; 95% confidence interval, 1.03 to 1.11) when compared with Monday surgery. This association was stronger in certain surgery types. There were 9,197 (3.1%) patients who were not discharged on the day of surgery; no association between day of the week and unsuccessful discharge was identified. Conclusion On a population level, there was a small effect of the day of the week of ambulatory surgery on outcomes; however, the clinical impact is likely not relevant. Certain surgical types may be more susceptible to a day of the week effect, but more research is needed to elucidate this notion. RésuméObjectif En règle générale, les chirurgies ambulatoires sont considérées comme étant sécuritaires; toutefois, jusqu'à 3 % des patients nécessitent des soins postopératoires aigus non planifiés. L'objectif de cette étude était de mesurer l'impact du jour de la semaine durant lequel la chirurgie a eu lieu sur les pronostics de chirurgie ambulatoire. Méthode À l'aide des données administratives de santé basées sur la population, nous avons réalisé une analyse de cohorte historique en identifiant les patients ayant subi une chirurgie ambulatoire entre 2002 et 2012. Nous avons utilisé une analyse par régression multivariée pour mesurer l'association entre le jour de la semaine au

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Identifying Patients with Physician‐Diagnosed Asthma in Health Administrative Databases

Abstract: Definitions of adult asthma using health administrative data are sensitive and specific for identifying adults with asthma. Using these definitions, cohorts of adults with asthma for ongoing population-based surveillance and research can be developed.

Cited by 353 publications

References 11 publications

Association of Frailty and Long‐Term Survival in Patients Undergoing Coronary Artery Bypass Grafting

Association of Frailty and Long‐Term Survival in Patients Undergoing Coronary Artery Bypass Grafting

Prevalence and Long‐Term Survival After Coronary Artery Bypass Grafting in Women and Men With Heart Failure and Preserved Versus Reduced Ejection Fraction

Impact of ambulatory surgery day of the week on postoperative outcomes: a population-based cohort study

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