Coronary disease surveillance in Olmsted County objectives and methodology
Coronary disease surveillance in Olmsted County objectives and methodology
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DOI：
10.1016/s0895-4356(02)00390-6
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发表时间：
2002-06-01
影响因子：
7.2
通讯作者：
Jacobsen, SJ
中科院分区：
文献类型：
--
作者：
Roger, VL;Killian, J;Jacobsen, SJ
（MI）发病率、病死率和冠心病死亡率，同时包括所有年龄。本研究的一个显著特点是它能够通过罗切斯特流行病学项目的医疗记录链接系统获取索引事件前后的纵向数据。本报告的目的是描述用于测量冠心病趋势的方法，包括老年人对心肌梗死确定的影响以及发生心肌梗死的人既往冠心病的趋势。这些方法基于标准化标准，包括审查死亡证明信息和医院记录，以确定冠心病死亡，以及奥姆斯特德县的心肌梗死事件。在罗切斯特流行病学项目的支持下，医疗记录链接系统被用来确定先前的冠心病和结果。从编码为ICD9代码410-414的采样事件中筛选住院MIs，并使用酶值、心脏疼痛和ECG编码进行分类。在筛选了5042个记录后，有1658个经过验证的MIs队列，其中35%（575）的患者年龄在75岁或以上。在老年人中，伴有心脏疼痛和酶的MIs比例低于75岁以下的人群（分别为35%和29%，P < 0.001）。在两个年龄层中，不需要ECG编码而验证的事件比例随着时间的推移而下降（P为趋势。001）。信度分析表明，事件分类具有良好的一致性。超过一半的事件MIs先前没有冠心病，并且这一比例随着时间的推移而增加。这些数据表明，老年人约占突发心肌梗死病例的三分之一，强调了包括所有年龄以充分表征CHID负担的重要性。老年人的病例更频繁地需要心电编码进行验证，但标准化的确定程序在所有年龄组中都是可行和可靠的。超过一半的MIs发生在没有冠心病的人群中，这一比例随着时间的推移而增加。标准化的方法和通过罗切斯特流行病学项目记录链接系统的纵向数据的结合，将允许对冠心病趋势进行可靠的测量，并有助于确定预防策略。(C) 2002爱思唯尔科学有限公司版权所有。
(MI) incidence, case fatality rate, and CHD mortality, while including all ages. A distinctive feature of this study is its ability to capture longitudinal data before and after index events via the medical record linkage system of the Rochester Epidemiology Project. The goal of this report is to describe the methods implemented to measure CHD trends, the implications of including elderly individuals on MI ascertainment and trends in prior CHD among persons with incident MI. The methods are based on standardized criteria involving the review of death certificate information and hospital records to identify CHD deaths, and incident MIs in Olmsted County. The medical record linkage system in place under the auspices of the Rochester Epidemiology Project was used to ascertain antecedent CHD and outcomes. Hospitalized MIs were screened from sampled events coded ICD9 codes 410-414 and classified using enzyme values, cardiac pain, and ECG coding. After screening 5,042 records, a cohort of 1,658 validated incident MIs was assembled 35% (575) among persons aged 75 years or greater. The proportion of MIs validated with cardiac pain and enzymes without Minnesota ECG coding was lower among the elderly than among persons less than 75 years of age (35 vs. 29%, respectively; P < .001). The proportion of events validated without requiring ECG coding decreased over time in both age strata (P for trend.001). Reliability analyses indicated excellent agreement in event classification. More than half of the incident MIs did not have antecedent CHD, and this proportion increased overtime. These data indicate that the elderly contribute approximately one-third of the cases of incident MI, underscoring the importance of including all ages to fully characterize the burden of CHID. Cases among elderly persons more frequently require ECG coding for validation, but standardized ascertainment procedures are feasible and reliable in all age groups. More than half of the incident MIs occurred among persons with no prior CHD, and this proportion increased over time. The combination of standardized methodology and of the longitudinal data via the record linkage system of the Rochester Epidemiology Project will allow reliable measures of CHD trends and help define preventive strategies. (C) 2002 Elsevier Science Inc. All rights reserved.