Identification of Cases of Myocardial Infarction: Hospital Discharge Data and Mortality Data Compared to Myocardial Infarction Community Registers

Abstract

Identification of incident myocardial infarction (MI) cases in a defined population using hospital discharge data and mortality data in combination has been suggested. This method of case identification was compared to that of use of MI community registers set up in accordance with principles adopted in a World Health Organization collaborative programme. The comparison comprised data for four Swedish cities over a number of years. On average 81% of incident hospital-treated cases below 65 years of age identified through MI community registers were found by the retrospective use of the method based on hospital discharge data and mortality data. Of hospital-treated cases identified by the latter method, 83% were also found by the MI community registers. For cases fulfilling the diagnostic criteria employed by the MI community registers this proportion would be higher, probably 87%-92%. Several reasons for cases being missed by either method were suggested by the results. According to the findings of this study, the case identification of the method based on hospital discharge data and mortality data seems to be somewhat less efficient compared to use of MI community registers. This may be of importance in descriptive epidemiological studies, but is of less significance in analytical studies. The relative efficiency of the former method could be improved by a more reliable system for the recording of hospital discharges. If supplemented by a validation procedure, it could yield sufficiently accurate data for many epidemiological applications at a fairly low cost.

Genetic Susceptibility of Myocardial Infarction

“…All AMI events that occur 28 days after the date of admission are treated as new events. More detailed information regarding the register is presented elsewhere (Hammar et al, 1991).…”

Validity of coronary heart diseases and heart failure based on hospital discharge and mortality data in the Netherlands using the cardiovascular registry Maastricht cohort study

“…Therefore, several studies have investigated the validity of data about CHD or acute myocardial infarction in national registers by comparing them with specific study registers [8][9][10][11][12][13][14][15]. These studies showed a wide range in the estimated values for the validity of the data in national registers.…”

Myocardial infarction in Swedish subway drivers

“…However, the confidence intervals were reasonably narrow, and a true excess risk greater than about 30% seems very unlikely. The method of identifying cases has been evaluated previously and found to have a high agreement with established diagnostic criteria for myocardial infarction (17)(18)(19). Table 2.…”

“…The study population consisted of all men 40 to 69 years of age residing in Stockholm County during the period 1976-1996. We identified incident cases of acute myocardial infarction in the study population by using registers of hospital discharges and deaths (17)(18)(19). The method of case ascertainment has been validated and found to have a high sensitivity for identifying new cases of myocardial infarction in a defined population and also a high positive predictive value for Sweden (20) and Stockholm County (19).…”