Electronic health record-wide association study for atrial fibrillation in a British cohort
BackgroundAtrial fibrillation (AF) confers a major healthcare burden from hospitalisations and AF-related complications, such as stroke and heart failure. We performed an electronic health records-wide association study to identify the most frequent reasons for healthcare utilization, pre and post n...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-09-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1204892/full |
| _version_ | 1797671305491775488 |
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| author | Sheng-Chia Chung Amand F. Schmit Gregory Y. H. Lip Gregory Y. H. Lip Rui Providencia Rui Providencia |
| author_facet | Sheng-Chia Chung Amand F. Schmit Gregory Y. H. Lip Gregory Y. H. Lip Rui Providencia Rui Providencia |
| author_sort | Sheng-Chia Chung |
| collection | DOAJ |
| description | BackgroundAtrial fibrillation (AF) confers a major healthcare burden from hospitalisations and AF-related complications, such as stroke and heart failure. We performed an electronic health records-wide association study to identify the most frequent reasons for healthcare utilization, pre and post new-onset AF.MethodsProspective cohort study with the linked electronic health records of 5.6 million patients in the United Kingdom Clinical Practice Research Datalink (1998–2016). A cohort study with AF patients and their age-and sex matched controls was implemented to compare the top 100 reasons of frequent hospitalisation and primary consultation.ResultsOf the 199,433 patients who developed AF, we found the most frequent healthcare interactions to be cardiac, cerebrovascular and peripheral-vascular conditions, both prior to AF diagnosis (41/100 conditions in secondary care, such as cerebral infarction and valve diseases; and 33/100 conditions in primary care), and subsequently (47/100 conditions hospital care and 48 conditions in primary care). There was a high representation of repeated visits for cancer and infection affecting multiple organ systems. We identified 10 novel conditions which have not yet been associated with AF: folic acid deficiency, pancytopenia, idiopathic thrombocytopenic purpura, seborrheic dermatitis, lymphoedema, angioedema, laryngopharyngeal reflux, rib fracture, haemorrhagic gastritis, inflammatory polyneuropathies.ConclusionOur nationwide data provide knowledge and better understanding of the clinical needs of AF patients suggesting: (i) groups at higher risk of AF, where screening may be more cost-effective, and (ii) potential complications developing following new-onset AF that can be prevented through implementation of comprehensive integrated care management and more personalised, tailored treatment.Clinical trial registrationNCT04786366 |
| first_indexed | 2024-03-11T21:13:24Z |
| format | Article |
| id | doaj.art-01d4b2eef0794ad9a10c4b60e90b3ed9 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-03-11T21:13:24Z |
| publishDate | 2023-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-01d4b2eef0794ad9a10c4b60e90b3ed92023-09-29T05:44:18ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-09-011010.3389/fcvm.2023.12048921204892Electronic health record-wide association study for atrial fibrillation in a British cohortSheng-Chia Chung0Amand F. Schmit1Gregory Y. H. Lip2Gregory Y. H. Lip3Rui Providencia4Rui Providencia5Institute of Health Informatics, University College London, London, United KingdomInstitute of Cardiovascular Science, University College London, London, United KingdomLiverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United KingdomDanish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, DenmarkInstitute of Health Informatics, University College London, London, United KingdomBarts Heart Centre, Barts Health NHS Trust, London, United KingdomBackgroundAtrial fibrillation (AF) confers a major healthcare burden from hospitalisations and AF-related complications, such as stroke and heart failure. We performed an electronic health records-wide association study to identify the most frequent reasons for healthcare utilization, pre and post new-onset AF.MethodsProspective cohort study with the linked electronic health records of 5.6 million patients in the United Kingdom Clinical Practice Research Datalink (1998–2016). A cohort study with AF patients and their age-and sex matched controls was implemented to compare the top 100 reasons of frequent hospitalisation and primary consultation.ResultsOf the 199,433 patients who developed AF, we found the most frequent healthcare interactions to be cardiac, cerebrovascular and peripheral-vascular conditions, both prior to AF diagnosis (41/100 conditions in secondary care, such as cerebral infarction and valve diseases; and 33/100 conditions in primary care), and subsequently (47/100 conditions hospital care and 48 conditions in primary care). There was a high representation of repeated visits for cancer and infection affecting multiple organ systems. We identified 10 novel conditions which have not yet been associated with AF: folic acid deficiency, pancytopenia, idiopathic thrombocytopenic purpura, seborrheic dermatitis, lymphoedema, angioedema, laryngopharyngeal reflux, rib fracture, haemorrhagic gastritis, inflammatory polyneuropathies.ConclusionOur nationwide data provide knowledge and better understanding of the clinical needs of AF patients suggesting: (i) groups at higher risk of AF, where screening may be more cost-effective, and (ii) potential complications developing following new-onset AF that can be prevented through implementation of comprehensive integrated care management and more personalised, tailored treatment.Clinical trial registrationNCT04786366https://www.frontiersin.org/articles/10.3389/fcvm.2023.1204892/fullarrhythmiaelectronic health recordsclinical visitspopulation studyhospitalizationprimary care |
| spellingShingle | Sheng-Chia Chung Amand F. Schmit Gregory Y. H. Lip Gregory Y. H. Lip Rui Providencia Rui Providencia Electronic health record-wide association study for atrial fibrillation in a British cohort Frontiers in Cardiovascular Medicine arrhythmia electronic health records clinical visits population study hospitalization primary care |
| title | Electronic health record-wide association study for atrial fibrillation in a British cohort |
| title_full | Electronic health record-wide association study for atrial fibrillation in a British cohort |
| title_fullStr | Electronic health record-wide association study for atrial fibrillation in a British cohort |
| title_full_unstemmed | Electronic health record-wide association study for atrial fibrillation in a British cohort |
| title_short | Electronic health record-wide association study for atrial fibrillation in a British cohort |
| title_sort | electronic health record wide association study for atrial fibrillation in a british cohort |
| topic | arrhythmia electronic health records clinical visits population study hospitalization primary care |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1204892/full |
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