Skip to content

Research at St Andrews

Linking hospital patient records for suspected or established acute coronary syndrome in a complex secondary care system: a proof-of-concept e-registry in National Health Service Scotland

Research output: Contribution to journalArticle


Iain Findlay, Tamsin Morris, Ruiqi Zhang, Colin McCowan, Sarah Shield, Brian Forbes, Alex McConnachie, Kenneth Mangion, Colin Berry

School/Research organisations


Aims To implement secondary care electronic record linkage for patients hospitalized with suspected or known acute coronary syndrome (ACS) in a complex regional health care system and evaluate this e-Registry in terms of patterns of service delivery and 1-year outcomes.

Methods and results Existing electronic hospital records were linked to create episodes of care using (i) a patient administration system, (ii) invasive cardiovascular procedure referrals, and (iii) a catheter laboratory record. Data were extracted for admissions (1 October 2013-30 September 2014) with International Classification of Disease (ICD)-10 diagnosis of angina (I200-I209), myocardial infarction (I210-I229), other ischaemic heart disease (I240-I249) or heart failure (I50), linked to other sources to develop a secondary care ACS e-registry and analysed within a Safe Haven. Episodes of care were categorized into care pathways and evaluated in terms of patient characteristics, as well as service delivery metrics and outcomes including mortality. In all, 2327 patients had 2472 episodes of care. Diagnoses were hierarchically classified as ST-elevation myocardial infarction (STEMI) (586, 25.2%), non-ST-elevation myocardial infarction (NSTEMI) (1068, 45.9%), unspecified myocardial infarction (146, 6.3%), unstable angina (527, 22.6%) for the first hospitalization for each patient within the study period. Six care pathways were mapped. Percutaneous coronary intervention rate for STEMI was 80.2% and for NSTEMI 33.1%. Unadjusted all-cause mortality was 9.0% and 3.0% for STEMI and NSTEMI at 30 days, rising to 11.9% and 11.6% at 1 year. Analyses were validated by independent source data verification.

Conclusion The e-registry has enabled analysis of ACS hospitalizations in a complex health care system with implications for quality improvement and research.


Original languageEnglish
Pages (from-to)155-167
JournalEuropean Heart Journal - Quality of Care and Clinical Outcomes
Issue number3
Early online date16 Feb 2018
Publication statusPublished - Jul 2018

    Research areas

  • Acute coronary syndrome, Prognosis, Electronic health records, Registry

Discover related content
Find related publications, people, projects and more using interactive charts.

View graph of relations

Related by author

  1. Impact of COVID-19 on accident and emergency attendances and emergency and planned hospital admissions in Scotland: an interrupted time-series analysis

    Mulholland, R. H., Wood, R., Stagg, H. R., Fischbacher, C., Villacampa, J., Simpson, C. R., Vaseleiou, E., McCowan, C., Stock, S. J., Docherty, A. B., Ritchie, L. D., Agrawal, U., Robertson, C., Murray, J. L. K., MacKenzie, F. & Sheikh, A., 4 Oct 2020, In : Journal of the Royal Society of Medicine. Online First

    Research output: Contribution to journalArticle

  2. Changes over a decade in psychotropic prescribing for people with intellectual disabilities: prospective cohort study

    Henderson, A., Mcskimming, P., Kinnear, D., McCowan, C., McIntosh, A., Allan, L. & Cooper, S. A., 10 Sep 2020, In : BMJ Open. 10, 9, 9 p., e036862.

    Research output: Contribution to journalArticle

  3. Earlier diagnosis of lung cancer in a randomised trial of an autoantibody blood test followed by imaging

    Sullivan, F. M., Mair, F. S., Anderson, W., Armory, P., Briggs, A., Chew, C., Dorward, A., Haughney, J., Hogarth, F., Kendrick, D., Littleford, R., Mcconnachie, A., McCowan, C., Mcmeekin, N., Patel, M., Rauchhaus, P., Ritchie, L., Robertson, C., Robertson, J., Robles-Zurita, J. & 8 others, Sarvesvaran, J., Sewell, H., Sproule, M., Taylor, T., Tello, A., Treweek, S., Vedhara, K. & Schembri, S., 30 Jul 2020, In : European Respiratory Journal. Early View, 2000670.

    Research output: Contribution to journalArticle

  4. Cost burden of Clostridioides difficile infection to the health service: a retrospective cohort study in Scotland

    Robertson, C., Pan, J., Kavanagh, K., Ford, I., McCowan, C., Bennie, M., Marwick, C. & Leanord, A., 24 Jul 2020, In : Journal of Hospital Infection. In press

    Research output: Contribution to journalArticle

  5. Linkage of national health and social care data: a cross-sectional study of multimorbidity and social care use in people aged over 65 years in Scotland

    Henderson, D. A. G., Atherton, I., McCowan, C., Mercer, S. W. & Bailey, N., 16 Jul 2020, In : Age and Ageing. Advance Article, 7 p., afaa134.

    Research output: Contribution to journalArticle

Related by journal

  1. Healthcare disparities for women hospitalised with myocardial infarction and angina

    Jackson, A. M., Zhang, R., Robertson, K., Lindsay, M., Morris, T., Forbes, B., Papworth, R., McConnachie, A., Mangion, K., Jhund, P. S., McCowan, C. & Berry, C., 25 Jul 2019, In : European Heart Journal - Quality of Care and Clinical Outcomes.

    Research output: Contribution to journalArticle

  2. Modelling total coronary heart disease burden and long-term benefit of cholesterol lowering in middle aged men with and without a history of cardiovascular disease

    Packard, C. J., Young, R., Ross, K., Ford, I., Ambegaonkar, B. M., Brudi, P. & McCowan, C., Oct 2017, In : European Heart Journal - Quality of Care and Clinical Outcomes. 3, 4, p. 281-288

    Research output: Contribution to journalArticle

ID: 257571959