scholarly journals Factors associated with deaths due to COVID-19 versus other causes: population-based cohort analysis of UK primary care data and linked national death registrations within the OpenSAFELY platform

2021 ◽  
Author(s):  
K Bhaskaran ◽  
SCJ Bacon ◽  
SJW Evans ◽  
CJ Bates ◽  
CT Rentsch ◽  
...  
Keyword(s):  
Primary Care ◽  
South Asian ◽  
Health Research ◽  
Cohort Analysis ◽  
Logistic Models ◽  
Smoking History ◽  
Research Centre ◽  
Individual Level ◽  
Factors Associated ◽  
Primary Care Data

ABSTRACTBackgroundMortality from COVID-19 shows a strong relationship with age and pre-existing medical conditions, as does mortality from other causes. However it is unclear how specific factors are differentially associated with COVID-19 mortality as compared to mortality from other causes.MethodsWorking on behalf of NHS England, we carried out a cohort study within the OpenSAFELY platform. Primary care data from England were linked to national death registrations. We included all adults (aged ≥18 years) in the database on 1st February 2020 and with >1 year of continuous prior registration, the cut-off date for deaths was 9th November 2020. Associations between individual-level characteristics and COVID-19 and non-COVID deaths were estimated by fitting age- and sex-adjusted logistic models for these two outcomes.Results17,456,515 individuals were included. 17,063 died from COVID-19 and 134,316 from other causes. Most factors associated with COVID-19 death were similarly associated with non-COVID death, but the magnitudes of association differed. Older age was more strongly associated with COVID-19 death than non-COVID death (e.g. ORs 40.7 [95% CI 37.7-43.8] and 29.6 [28.9-30.3] respectively for ≥80 vs 50-59 years), as was male sex, deprivation, obesity, and some comorbidities. Smoking, history of cancer and chronic liver disease had stronger associations with non-COVID than COVID-19 death. All non-white ethnic groups had higher odds than white of COVID-19 death (OR for Black: 2.20 [1.96-2.47], South Asian: 2.33 [2.16-2.52]), but lower odds than white of non-COVID death (Black: 0.88 [0.83-0.94], South Asian: 0.78 [0.75-0.81]).InterpretationSimilar associations of most individual-level factors with COVID-19 and non-COVID death suggest that COVID-19 largely multiplies existing risks faced by patients, with some notable exceptions. Identifying the unique factors contributing to the excess COVID-19 mortality risk among non-white groups is a priority to inform efforts to reduce deaths from COVID-19.FundingWellcome, Royal Society, National Institute for Health Research, National Institute for Health Research Oxford Biomedical Research Centre, UK Medical Research Council, Health Data Research UK.

scholarly journals Factors associated with costs and health outcomes in patients with Back and leg pain in primary care: a prospective cohort analysis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jesse Kigozi ◽  
Kika Konstantinou ◽  
Reuben Ogollah ◽  
Kate Dunn ◽  
Lewis Martyn ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Outcomes ◽  
Prospective Cohort ◽  
Cohort Analysis ◽  
Leg Pain ◽  
Factors Associated

scholarly journals Using primary care data for health research in England – an overview

2018 ◽  
Vol 5 (3) ◽  
pp. 207-212 ◽  
Author(s):  
Stephen H Bradley ◽  
Neil R Lawrence ◽  
Paul Carder
Keyword(s):  
Primary Care ◽  
Health Research ◽  
Primary Care Data

scholarly journals Do GPs accurately record date of death? A UK observational analysis

2018 ◽  
Vol 10 (3) ◽  
pp. e24-e24 ◽  
Author(s):  
Amelia Harshfield ◽  
Gary A Abel ◽  
Stephen Barclay ◽  
Rupert A Payne
Keyword(s):  
Primary Care ◽  
Young Patients ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Data Sets ◽  
Factors Associated ◽  
National Statistics ◽  
Primary Care Data ◽  
National Mortality ◽  
General Practices

ObjectiveTo examine the concordance between dates of death recorded in UK primary care and national mortality records.MethodsUK primary care data from the Clinical Practice Research Datalink were linked to Office for National Statistics (ONS) data, for 118 571 patients who died between September 2010 and September 2015. Logistic regression was used to examine factors associated with discrepancy in death dates between data sets.ResultsDeath dates matched in 76.8% of cases with primary care dates preceding ONS date in 2.9%, and following in 20.3% of cases; 92.2% of cases differed by <2 weeks. Primary care date was >4 weeks later than ONS in 1.5% of cases and occurred more frequently with deaths categorised as ‘external’ (15.8% vs 0.8% for cancer), and in younger patients (15.9% vs 1% for 18–29 and 80–89 years, respectively). General practices with the greatest discrepancies (97.5th percentile) had around 200 times higher odds of recording substantially discordant dates than practices with the lowest discrepancies (2.5th percentile).ConclusionDates of death in primary care records often disagree with national records and should be treated with caution. There is marked variation between practices, and studies involving young patients, unexplained deaths and where precise date of death is important are particularly vulnerable to these issues.

A national survey of the management of atrial fibrillation with antithrombotic drugs in Italian primary care

2010 ◽  
Vol 103 (05) ◽  
pp. 968-975 ◽  
Author(s):  
Alessandro Filippi ◽  
Marianna Alacqua ◽  
Warren Cowell ◽  
Annabelle Shakespeare ◽  
Lorenzo Mantovani ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Primary Care ◽  
Risk Stratification ◽  
Primary Care Physicians ◽  
Stroke Risk ◽  
Risk Profile ◽  
Antithrombotic Drugs ◽  
Factors Associated ◽  
Primary Care Data ◽  
Males And Females

SummaryThe aims of this study were to investigate trends in the incidence of diagnosed atrial fibrillation (AF), and to identify factors associated with the prescription of antithrombotics (ATs) and to identify the persistence of patients with oral anticoagulant (OAC) treatment in primary care. Data were obtained from 400 Italian primary care physicians providing information to the Health Search/Thales Database from 2001 to 2004. The age-standardised incidence of AF was: 3.9–3.0 cases, and 3.6–3.0 cases per 1,000 person-years in males and females, respectively. During the study period, 2,016 (37.2%) patients had no prescription, 1,663 (30.7%) were prescribed an antiplatelet (AP) agent, 1,440 (26.6%) were prescribed an OAC and 301 (5.5%) had both prescriptions. The date of diagnosis (p = 0.0001) affected the likelihood of receiving an OAC. AP, but not OAC, use significantly increased with a worsening stroke risk profile using the CHADS2 risk score. Older age increased the probability (p < 0.0001) of receiving an AP, but not an OAC. Approximately 42% and 24% of patients persisted with OAC treatment at one and two years, respectively, the remainder interrupted or discontinued their treatment. Underuse and discontinuation of OAC treatment is common in incident AF patients. Risk stratification only partially influences AT management.

ASSESSING POPULATION DYNAMICS IN A RURAL AFRICAN SOCIETY: THE NAVRONGO DEMOGRAPHIC SURVEILLANCE SYSTEM

1999 ◽  
Vol 31 (3) ◽  
pp. 375-391 ◽  
Author(s):  
FRED N. BINKA ◽  
PIERRE NGOM ◽  
JAMES F. PHILLIPS ◽  
KUBAJE ADAZU ◽  
BRUCE B. MacLEOD
Keyword(s):  
Health Research ◽  
Surveillance System ◽  
Demographic Data ◽  
Demographic Surveillance System ◽  
Northern Ghana ◽  
Research Centre ◽  
High Fertility ◽  
Demographic Research ◽  
Individual Level ◽  
The Impact

In 1993, the Navrongo Health Research Centre launched a new demographic research system for monitoring the impact of health service interventions in a rural district of northern Ghana. The Navrongo Demographic Surveillance System uses automated software generation procedures that greatly simplify the preparation of complex database management systems. This paper reviews the Navrongo model for data collection, as well as features of the Navrongo system that have led to its replication in other health research projects requiring individual-level longitudinal demographic data. Demographic research results for the first 2 years of system operation are indicative of a pretransitional rural society with high fertility, exceedingly high mortality risks, and pronounced seasonal out-migration.

scholarly journals HIV infection and COVID-19 death: population-based cohort analysis of UK primary care data and linked national death registrations within the OpenSAFELY platform

2020 ◽  
Author(s):  
Krishnan Bhaskaran ◽  
Christopher T Rentsch ◽  
Brian MacKenna ◽  
Anna Schultz ◽  
Amir Mehrkar ◽  
...  
Keyword(s):  
Primary Care ◽  
Hiv Infection ◽  
Cox Regression ◽  
Cohort Analysis ◽  
Geographical Area ◽  
Population Based ◽  
People Living With Hiv ◽  
Primary Care Data ◽  
Living With Hiv ◽  
Age And Sex

Background: It is unclear whether HIV infection is associated with risk of COVID-19 death. We aimed to investigate this in a large-scale population-based study in England. Methods: Working on behalf of NHS England, we used the OpenSAFELY platform to analyse routinely collected electronic primary care data linked to national death registrations. People with a primary care record for HIV infection were compared to people without HIV. COVID-19 death was defined by ICD-10 codes U07.1 or U07.2 anywhere on the death certificate. Cox regression models were used to estimate the association between HIV infection and COVID-19 death, initially adjusted for age and sex, then adding adjustment for index of multiple deprivation and ethnicity, and finally for a broad range of comorbidities. Interaction terms were added to assess effect modification by age, sex, ethnicity, comorbidities and calendar time. Results: 17.3 million adults were included, of whom 27,480 (0.16%) had HIV recorded. People living with HIV were more likely to be male, of black ethnicity, and from a more deprived geographical area than the general population. There were 14,882 COVID-19 deaths during the study period, with 25 among people with HIV. People living with HIV had nearly three-fold higher risk of COVID-19 death than those without HIV after adjusting for age and sex (HR=2.90, 95% CI 1.96-4.30). The association was attenuated but risk remained substantially raised, after adjustment for deprivation and ethnicity (adjusted HR=2.52, 1.70-3.73) and further adjustment for comorbidities (HR=2.30, 1.55-3.41). There was some evidence that the association was larger among people of black ethnicity (HR = 3.80, 2.15-6.74, compared to 1.64, 0.92-2.90 in non-black individuals, p-interaction=0.045) Interpretation: HIV infection was associated with a markedly raised risk of COVID-19 death in a country with high levels of antiretroviral therapy coverage and viral suppression; the association was larger in people of black ethnicity.

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