Leveraging Clinical Digitized Data to Understand Temporal Characteristics and Outcomes of Acute Myocardial Infarctions at a Tertiary Care Medical Centre in Pakistan from 1988–2018 – Methods and Results

BACKGROUND AND OBJECTIVE: Few data exist on trends in acute myocardial infarction (AMI) patterns spanning recent epidemiological shifts in low middle-income countries (LMICs). To understand temporal disease patterns of AMI characteristics and outcomes between 1988–2018, we used digitized legacy clin...

Descripción completa

Detalles Bibliográficos
Autores principales: Samad, Zainab, Noorali, Ali Aahil, Farhad, Awais, Awan, Safia, Qureshi, Nada Qaiser, Mawani, Minaz, Ali, Mushyada, Masood, Laiba, Adnan, Ghufran, Shaw, Linda K., Jafary, Fahim Haider, Virani, Salim S., Velazquez, Eric J., Bhutta, Zulfiqar, Bloomfield, Gerald S., Tai, Javed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Ubiquity Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9389955/
https://www.ncbi.nlm.nih.gov/pubmed/36051315
http://dx.doi.org/10.5334/gh.1147
_version_ 1784770568895070208
author Samad, Zainab
Noorali, Ali Aahil
Farhad, Awais
Awan, Safia
Qureshi, Nada Qaiser
Mawani, Minaz
Ali, Mushyada
Masood, Laiba
Adnan, Ghufran
Shaw, Linda K.
Jafary, Fahim Haider
Virani, Salim S.
Velazquez, Eric J.
Bhutta, Zulfiqar
Bloomfield, Gerald S.
Tai, Javed
author_facet Samad, Zainab
Noorali, Ali Aahil
Farhad, Awais
Awan, Safia
Qureshi, Nada Qaiser
Mawani, Minaz
Ali, Mushyada
Masood, Laiba
Adnan, Ghufran
Shaw, Linda K.
Jafary, Fahim Haider
Virani, Salim S.
Velazquez, Eric J.
Bhutta, Zulfiqar
Bloomfield, Gerald S.
Tai, Javed
author_sort Samad, Zainab
collection PubMed
description BACKGROUND AND OBJECTIVE: Few data exist on trends in acute myocardial infarction (AMI) patterns spanning recent epidemiological shifts in low middle-income countries (LMICs). To understand temporal disease patterns of AMI characteristics and outcomes between 1988–2018, we used digitized legacy clinical data at a large tertiary care centre in Pakistan. METHODS: We reviewed digital health information capture systems maintained across the Aga Khan University Hospital and obtained structured elements to create a master dataset. We included index admissions of patients >18 years that were discharged between January 1, 1988, and December 31, 2018, with a primary discharge diagnosis of AMI (using ICD-9 diagnoses). The outcome evaluated was in-hospital mortality. Clinical characteristics derived from the electronic database were validated against chart review in a random sample of cases (k 0.53–1.00). RESULTS: The final population consisted of 14,601 patients of which 30.6% (n = 4,470) were female, 52.4% (n = 7,651) had ST elevation MI and 47.6% (n = 6,950) had non-ST elevation MI. The median (IQR) age at presentation was 61 (52–70) years. Overall unadjusted in-hospital mortality was 10.3%. Across the time period, increasing trends were noted for the following characteristics: age, proportion of women, prevalence of hypertension, diabetes, proportion with NSTEMI (all p(trend) < 0.001). In-hospital mortality rates declined significantly between 1988–1997 and 2008–2018 (13.8% to 9.2%, p < 0.001). CONCLUSIONS: The patterns of AMI have changed over the last three decades with a concomitant decline in in-hospital mortality at a tertiary care centre in Pakistan. Clinical digitized data presents a unique opportunity for gaining insights into disease patterns in LMICs.
format Online
Article
Text
id pubmed-9389955
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Ubiquity Press
record_format MEDLINE/PubMed
spelling pubmed-93899552022-08-31 Leveraging Clinical Digitized Data to Understand Temporal Characteristics and Outcomes of Acute Myocardial Infarctions at a Tertiary Care Medical Centre in Pakistan from 1988–2018 – Methods and Results Samad, Zainab Noorali, Ali Aahil Farhad, Awais Awan, Safia Qureshi, Nada Qaiser Mawani, Minaz Ali, Mushyada Masood, Laiba Adnan, Ghufran Shaw, Linda K. Jafary, Fahim Haider Virani, Salim S. Velazquez, Eric J. Bhutta, Zulfiqar Bloomfield, Gerald S. Tai, Javed Glob Heart Original Research BACKGROUND AND OBJECTIVE: Few data exist on trends in acute myocardial infarction (AMI) patterns spanning recent epidemiological shifts in low middle-income countries (LMICs). To understand temporal disease patterns of AMI characteristics and outcomes between 1988–2018, we used digitized legacy clinical data at a large tertiary care centre in Pakistan. METHODS: We reviewed digital health information capture systems maintained across the Aga Khan University Hospital and obtained structured elements to create a master dataset. We included index admissions of patients >18 years that were discharged between January 1, 1988, and December 31, 2018, with a primary discharge diagnosis of AMI (using ICD-9 diagnoses). The outcome evaluated was in-hospital mortality. Clinical characteristics derived from the electronic database were validated against chart review in a random sample of cases (k 0.53–1.00). RESULTS: The final population consisted of 14,601 patients of which 30.6% (n = 4,470) were female, 52.4% (n = 7,651) had ST elevation MI and 47.6% (n = 6,950) had non-ST elevation MI. The median (IQR) age at presentation was 61 (52–70) years. Overall unadjusted in-hospital mortality was 10.3%. Across the time period, increasing trends were noted for the following characteristics: age, proportion of women, prevalence of hypertension, diabetes, proportion with NSTEMI (all p(trend) < 0.001). In-hospital mortality rates declined significantly between 1988–1997 and 2008–2018 (13.8% to 9.2%, p < 0.001). CONCLUSIONS: The patterns of AMI have changed over the last three decades with a concomitant decline in in-hospital mortality at a tertiary care centre in Pakistan. Clinical digitized data presents a unique opportunity for gaining insights into disease patterns in LMICs. Ubiquity Press 2022-08-18 /pmc/articles/PMC9389955/ /pubmed/36051315 http://dx.doi.org/10.5334/gh.1147 Text en Copyright: © 2022 The Author(s) https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/.
spellingShingle Original Research
Samad, Zainab
Noorali, Ali Aahil
Farhad, Awais
Awan, Safia
Qureshi, Nada Qaiser
Mawani, Minaz
Ali, Mushyada
Masood, Laiba
Adnan, Ghufran
Shaw, Linda K.
Jafary, Fahim Haider
Virani, Salim S.
Velazquez, Eric J.
Bhutta, Zulfiqar
Bloomfield, Gerald S.
Tai, Javed
Leveraging Clinical Digitized Data to Understand Temporal Characteristics and Outcomes of Acute Myocardial Infarctions at a Tertiary Care Medical Centre in Pakistan from 1988–2018 – Methods and Results
title Leveraging Clinical Digitized Data to Understand Temporal Characteristics and Outcomes of Acute Myocardial Infarctions at a Tertiary Care Medical Centre in Pakistan from 1988–2018 – Methods and Results
title_full Leveraging Clinical Digitized Data to Understand Temporal Characteristics and Outcomes of Acute Myocardial Infarctions at a Tertiary Care Medical Centre in Pakistan from 1988–2018 – Methods and Results
title_fullStr Leveraging Clinical Digitized Data to Understand Temporal Characteristics and Outcomes of Acute Myocardial Infarctions at a Tertiary Care Medical Centre in Pakistan from 1988–2018 – Methods and Results
title_full_unstemmed Leveraging Clinical Digitized Data to Understand Temporal Characteristics and Outcomes of Acute Myocardial Infarctions at a Tertiary Care Medical Centre in Pakistan from 1988–2018 – Methods and Results
title_short Leveraging Clinical Digitized Data to Understand Temporal Characteristics and Outcomes of Acute Myocardial Infarctions at a Tertiary Care Medical Centre in Pakistan from 1988–2018 – Methods and Results
title_sort leveraging clinical digitized data to understand temporal characteristics and outcomes of acute myocardial infarctions at a tertiary care medical centre in pakistan from 1988–2018 – methods and results
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9389955/
https://www.ncbi.nlm.nih.gov/pubmed/36051315
http://dx.doi.org/10.5334/gh.1147
work_keys_str_mv AT samadzainab leveragingclinicaldigitizeddatatounderstandtemporalcharacteristicsandoutcomesofacutemyocardialinfarctionsatatertiarycaremedicalcentreinpakistanfrom19882018methodsandresults
AT nooralialiaahil leveragingclinicaldigitizeddatatounderstandtemporalcharacteristicsandoutcomesofacutemyocardialinfarctionsatatertiarycaremedicalcentreinpakistanfrom19882018methodsandresults
AT farhadawais leveragingclinicaldigitizeddatatounderstandtemporalcharacteristicsandoutcomesofacutemyocardialinfarctionsatatertiarycaremedicalcentreinpakistanfrom19882018methodsandresults
AT awansafia leveragingclinicaldigitizeddatatounderstandtemporalcharacteristicsandoutcomesofacutemyocardialinfarctionsatatertiarycaremedicalcentreinpakistanfrom19882018methodsandresults
AT qureshinadaqaiser leveragingclinicaldigitizeddatatounderstandtemporalcharacteristicsandoutcomesofacutemyocardialinfarctionsatatertiarycaremedicalcentreinpakistanfrom19882018methodsandresults
AT mawaniminaz leveragingclinicaldigitizeddatatounderstandtemporalcharacteristicsandoutcomesofacutemyocardialinfarctionsatatertiarycaremedicalcentreinpakistanfrom19882018methodsandresults
AT alimushyada leveragingclinicaldigitizeddatatounderstandtemporalcharacteristicsandoutcomesofacutemyocardialinfarctionsatatertiarycaremedicalcentreinpakistanfrom19882018methodsandresults
AT masoodlaiba leveragingclinicaldigitizeddatatounderstandtemporalcharacteristicsandoutcomesofacutemyocardialinfarctionsatatertiarycaremedicalcentreinpakistanfrom19882018methodsandresults
AT adnanghufran leveragingclinicaldigitizeddatatounderstandtemporalcharacteristicsandoutcomesofacutemyocardialinfarctionsatatertiarycaremedicalcentreinpakistanfrom19882018methodsandresults
AT shawlindak leveragingclinicaldigitizeddatatounderstandtemporalcharacteristicsandoutcomesofacutemyocardialinfarctionsatatertiarycaremedicalcentreinpakistanfrom19882018methodsandresults
AT jafaryfahimhaider leveragingclinicaldigitizeddatatounderstandtemporalcharacteristicsandoutcomesofacutemyocardialinfarctionsatatertiarycaremedicalcentreinpakistanfrom19882018methodsandresults
AT viranisalims leveragingclinicaldigitizeddatatounderstandtemporalcharacteristicsandoutcomesofacutemyocardialinfarctionsatatertiarycaremedicalcentreinpakistanfrom19882018methodsandresults
AT velazquezericj leveragingclinicaldigitizeddatatounderstandtemporalcharacteristicsandoutcomesofacutemyocardialinfarctionsatatertiarycaremedicalcentreinpakistanfrom19882018methodsandresults
AT bhuttazulfiqar leveragingclinicaldigitizeddatatounderstandtemporalcharacteristicsandoutcomesofacutemyocardialinfarctionsatatertiarycaremedicalcentreinpakistanfrom19882018methodsandresults
AT bloomfieldgeralds leveragingclinicaldigitizeddatatounderstandtemporalcharacteristicsandoutcomesofacutemyocardialinfarctionsatatertiarycaremedicalcentreinpakistanfrom19882018methodsandresults
AT taijaved leveragingclinicaldigitizeddatatounderstandtemporalcharacteristicsandoutcomesofacutemyocardialinfarctionsatatertiarycaremedicalcentreinpakistanfrom19882018methodsandresults