Veterans Affairs patient database (VAPD 2014–2017): building nationwide granular data for clinical discovery

التفاصيل البيبلوغرافية
العنوان: Veterans Affairs patient database (VAPD 2014–2017): building nationwide granular data for clinical discovery
المؤلفون: Elizabeth M. Viglianti, Xiao Qing Wang, Theodore J. Iwashyna, Brenda M. Vincent, Kaitlyn A. Luginbill, Wyndy L. Wiitala, Hallie C. Prescott
المصدر: BMC Medical Research Methodology, Vol 19, Iss 1, Pp 1-9 (2019)
BMC Medical Research Methodology
بيانات النشر: BMC, 2019.
سنة النشر: 2019
مصطلحات موضوعية: Male, medicine.medical_specialty, Databases, Factual, Epidemiology, Specialty, Vital signs, Health Informatics, Healthcare database, Severity of Illness Index, Hospitalization, sepsis, law.invention, Database, 03 medical and health sciences, 0302 clinical medicine, law, Sepsis, medicine, Humans, Electronic health records, 030212 general & internal medicine, Hospital Mortality, Veterans Affairs, Aged, lcsh:R5-920, business.industry, 030503 health policy & services, Organ dysfunction, Laboratory values, Length of Stay, Middle Aged, Disease control, Intensive care unit, Hospitals, United States, Hospitalization, United States Department of Veterans Affairs, Critical illness, Emergency medicine, Female, medicine.symptom, 0305 other medical science, Patient database, business, Patient physiology, lcsh:Medicine (General)
الوصف: Background To study patient physiology throughout a period of acute hospitalization, we sought to create accessible, standardized nationwide data at the level of the individual patient-facility-day. This methodology paper summarizes the development, organization, and characteristics of the Veterans Affairs Patient Database 2014–2017 (VAPD 2014–2017). The VAPD 2014–2017 contains acute hospitalizations from all parts of the nationwide VA healthcare system with daily physiology including clinical data (labs, vitals, medications, risk scores, etc.), intensive care unit (ICU) indicators, facility, patient, and hospitalization characteristics. Methods The VA data structure and database organization represents a complex multi-hospital system. We define a single-site hospitalization as one or more consecutive stays with an acute treating specialty at a single facility. The VAPD 2014–2017 is structured at the patient-facility-day level, where every patient-day in a hospital is a row with separate identification variables for facility, patient, and hospitalization. The VAPD 2014–2017 includes daily laboratory, vital signs, and inpatient medication. Such data were validated and verified through lab value range and comparison with patient charts. Sepsis, risk scores, and organ dysfunction definitions were standardized and calculated. Results We identified 565,242 single-site hospitalizations (SSHs) in 2014; 558,060 SSHs in 2015; 553,961 SSHs in 2016; and 550,236 SSHs in 2017 at 141 VA hospitals. The average length of stay was four days for all study years. In-hospital mortality decreased from 2014 to 2017 (1.7 to 1.4%), 30-day readmission rates increased from 15.3% in 2014 to 15.6% in 2017; 30-day mortality also decreased from 4.4% in 2014 to 4.1% in 2017. From 2014 to 2017, there were 107,512 (4.8%) of SSHs that met the Center for Disease Control and Prevention’s Electronic Health Record-based retrospective definition of sepsis. Conclusion The VAPD 2014–2017 represents a large, standardized collection of granular data from a heterogeneous nationwide healthcare system. It is also a direct resource for studying the evolution of inpatient physiology during both acute and critical illness. Electronic supplementary material The online version of this article (10.1186/s12874-019-0740-x) contains supplementary material, which is available to authorized users.
اللغة: English
تدمد: 1471-2288
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::695637b81ed6c7ee002318339fe4a164Test
http://link.springer.com/article/10.1186/s12874-019-0740-xTest
حقوق: OPEN
رقم الانضمام: edsair.doi.dedup.....695637b81ed6c7ee002318339fe4a164
قاعدة البيانات: OpenAIRE