Population risk factor estimates for abdominal aortic aneurysm from electronic medical records: a case control study

BMC Cardiovascular Disorders

Research Article

James R Elmore¹  David P Franklin¹  H Lester Kirchner²  David J Carey³  Gerard Tromp³  Helena Kuivaniemi³  Diane T Smelser³ 

[1] Department of Vascular and Endovascular Surgery, Geisinger Health System, Danville, PA, USA;Henry Hood Center for Health Research, Geisinger Health System, Danville, PA, USA;Sigfried and Janet Weis Center for Research, Geisinger Health System, Danville, PA, USA;

关键词: Aortic Aneurysm;    Abdominal;    Electronic medical record;    Neoplasms;    Benign;    Risk factors;    Blood pressure;    Diabetes mellitus;    Type 2;    Case–control studies;   

DOI  :  10.1186/1471-2261-14-174

 received in 2013-05-31, accepted in 2014-11-18,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundUsing abdominal aortic aneurysm (AAA) as a model, this case–control study used electronic medical record (EMR) data to assess known risk factors and identify new associations.MethodsThe study population consisted of cases with AAA (n =888) and controls (n =10,523) from the Geisinger Health System EMR in Central and Northeastern Pennsylvania. We extracted all clinical and diagnostic data for these patients from January 2004 to December 2009 from the EMR. From this sample set, bootstrap replication procedures were used to randomly generate 2,500 iterations of data sets, each with 500 cases and 2000 controls. Estimates of risk factor effect sizes were obtained by stepwise logistic regression followed by bootstrap aggregation. Variables were ranked using the number of inclusions in iterations and P values.ResultsThe benign neoplasm diagnosis was negatively associated with AAA, a novel finding. Similarly, type 2 diabetes, diastolic blood pressure, weight and myelogenous neoplasms were negatively associated with AAA. Peripheral artery disease, smoking, age, coronary stenosis, systolic blood pressure, age, height, male sex, pulmonary disease and hypertension were associated with an increased risk for AAA.ConclusionsThis study utilized EMR data, retrospectively, for risk factor assessment of a complex disease. Known risk factors for AAA were replicated in magnitude and direction. A novel negative association of benign neoplasms was identified. EMRs allow researchers to rapidly and inexpensively use clinical data to expand cohort size and derive better risk estimates for AAA as well as other complex diseases.

【 授权许可】

CC BY   
© Smelser et al.; licensee BioMed Central Ltd. 2014