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Risk and outcomes of coagulopathies in acutely unwell patients

Population Size

16,456

People

Years

2015 - 2020

Associated BioSamples

None/not available

Geographic coverage

United Kingdom

England

Lead time

Less than 1 week

Summary

Patients admitted with a bleeding or clotting disorder. Granular care pathways. Multi-morbidity, investigations, interventions and treatments. Serial physiology, blood biomarkers, physiotherapy, outcome. Deeply phenotyped.

Documentation

Risk and outcomes of coagulopathies & arterial/venous thrombosis in acutely unwell patients Dataset number 12.0

Coagulopathies and bleeding disorders can reflect hereditary conditions such as Haemophilia or von Willebrand disease, be associated with other diseases such as liver conditions, sepsis, trauma or be iatrogenic, related to therapies or their side effects. Hospital associated venous thromboembolic (VTE) events remain common despite well known risk factors and effective prophylactic treatments. There are a number of blood biomarkers associated with coagulopathies, as well as genetic tests and treatments. This dataset focuses on the acute presentation of coagulopathies, including in people with known bleeding/clotting disorders and in people for present with a new clotting or bleeding events during an acute presentation.

PIONEER geography The West Midlands (WM) has a population of 5.9 million & includes a diverse ethnic & socio-economic mix. University Hospitals Birmingham NHS Foundation Trust is a Comprehensive Care Haemophilia Centre (CCC) and cares for a wide range of inherited bleeding disorders, including Haemophilia A and B, von Willebrand Disorder and other clotting factor and platelet disorders. UHB also has a mandated VTE risk and prescription prompt in the medical clerking, capturing risk factors and contraindications for anticoagulation.

EHR. UHB is one of the largest NHS Trusts in England, providing direct acute services & specialist care across four hospital sites, with 2.2 million patient episodes per year, 2750 beds & an expanded 250 ITU bed capacity during COVID. UHB runs a fully electronic healthcare record (EHR) (PICS; Birmingham Systems), a shared primary & secondary care record (Your Care Connected) & a patient portal “My Health”.

Scope: All patients admitted with coagulopathy or bleeding disorders (chronic or acute) from 2000 onwards. The dataset includes highly granular patient demographics & co-morbidities taken from ICD-10 & SNOMED-CT codes. Serial, structured data pertaining to acute care process (timings, staff grades, specialty review, wards), presenting complaint, diagnosis of TE or bleeds, clotting parameters, D-Dimers, acuity, all physiology readings (pulse, blood pressure, respiratory rate, oxygen saturations), all blood results, imaging reports, all prescribed & administered treatments (fluids, blood products, procedures), all outcomes.

Available supplementary data: Matched controls; ambulance, synthetic data.

Available supplementary support: Analytics, Model build, validation & refinement; A.I.; Data partner support for ETL (extract, transform & load) process, Clinical expertise, Patient & end-user access, Purchaser access, Regulatory requirements, Data-driven trials, “fast screen” services.

Dataset type
Health and disease, Treatments/Interventions
Dataset sub-type
Cardiovascular
Dataset population size
16456

Keywords

NHS, Acute, VTE, HAT, venous, arterial, bleed, clots, clotting, INR, APPT, prothrombin, platelets, thrombophlebitis, COVID, pneumonia, pneumonitis, NEWS2, deterioration, alert, SEWS, oxygen, non-invasive ventilation, high flow oxygen, NIV, CPAP, patient, acute hospitals, inpatient, ethnicity, multimorbidity, blood, biomarkers, physiology, demographics, treatments, aspirin, anti-coagulants, vitamin k, transfusions, interventions, outcomes, death, longitudinal, vital signs

Observations

Observed Node
Disambiguating Description
Measured Value
Measured Property
Observation Date

Persons

16456 spells in this dataset from 01.01.2015 to 18.11.2020

16456

Count

21 Dec 2020

Provenance

Purpose of dataset collection
Care
Source of data extraction
EPR
Collection source setting
Secondary care - In-patients
Patient pathway description
The West Midlands (WM) has a population of 5.9million & includes a diverse ethnic, socio-economic mix. There is a higher than average percentage of minority ethnic groups with Birmingham having a population which is >40% non-white. WM has a large number of elderly residents but Birmingham is one of the youngest cities in the UK. There is social deprivation and Birmingham’s population suffers with particularly high rates of illness including cerebrovascular Disease, physical inactivity, obesity, smoking, hypertension, ischaemic heart disease & diabetes. There are also high levels of rare diseases, especially immunometabolic conditions. The patients included in this dataset are representative of this diverse population and also include a wide age-range. University Hospitals Birmingham NHS Foundation Trust (UHB) is one of the largest NHS Trusts in England, providing direct acute services & specialist care across four hospital sites, with 2.2 million patient episodes per year, 2750 beds & 100 ITU beds. UHB runs a fully electronic healthcare record (EHR) (PICS Birmingham Systems), a shared primary & secondary care record (Your Care Connected) & a patient portal “My Health”. University Hospitals Birmingham NHS Foundation Trust is a Comprehensive Care Haemophilia Centre (CCC) and cares for a wide range of inherited bleeding disorders, including Haemophilia A and B, von Willebrand Disorder and other clotting factor and platelet disorders. UHB also has a mandated VTE risk and prescription prompt in the medical clerking,

capturing risk factors and contraindications for anticoagulation. This dataset includes the patient journey from admission to hospital to outcome for patients with known clotting or bleeding disorders or who develop them as a result of illness

, trauma or medical therapies/interventions. The data includes granular demography and co-morbidity, presenting symptoms and diagnoses, serial physiology and blood biomarkers, all investigations, all prescribed and administered treatments and outcomes. It can be supplemented with preceding and following health care contacts, to understand the risk for the acute admission and the subsequent impact on health after discharge. Although primarily secondary care, this dataset can be supplemented with ambulance and primary care data on request. PIONEER can also offer synthetic data, images and access to a secure Trusted Research Environment for analytics and AI. PIONEER can assist with analytics, model build, validation & refinement A.I. Data partner support for ETL (extract, transform & load) process, Clinical expertise, Patient & end-user access, Purchaser access, Regulatory requirements, Data-driven trials, “fast screen” services
Image contrast
Not stated
Biological sample availability
None/not available

Structural Metadata

Details

Publishing frequency
Quarterly
Version
1.0.0
Modified

08/10/2024

Distribution release date

21/12/2020

Citation Requirements
This publication uses data from PIONEER, an ethically approved database and analytical environment (East Midlands Derby Research Ethics 20/EM/0158)

Coverage

Start date

01/01/2015

End date

18/11/2020

Time lag
Other
Geographic coverage
United Kingdom, England, West Midlands
Minimum age range
10
Maximum age range
110
Follow-up
Other

Accessibility

Language
en
Alignment with standardised data models
LOCAL
Controlled vocabulary
OPCS4, SNOMED CT, ICD10
Format
SQL

Data Access Request

Dataset pipeline status
Available
Time to dataset access
Less than 1 week
Access request cost
www.pioneerdatahub.co.uk/data/data-services-costs/
Access method category
TRE/SDE
Access service description

Trusted Research Environments (TRE) are built using Microsoft Azure services and hosted in the UK to provide research teams a safe, secure and agile environment which allows users to quickly analyse, interpret and form an enriched view of primary care information through a range of integrated datasets.

Health data collated from multiple sources is ingested into a secure data lake which will then allow subsets of data to be made available to research teams on approval of a data request. Once approved a customer specific TRE is made available with a standard set of leading analytical tools from Microsoft including Azure Databricks, Azure Machine Learning, Azure SQL and Azure Synapse (for large-scale data warehouses). Specific tools can be provided at an additional cost over the standard platform data access charge and the PIONEER team will work with you to determine your exact needs.

Access to the TRE is managed using the latest virtual desktop technology to provide a safe and secure end-user experience. By utilising leading edge design PIONEER are able to create TREs rapidly to enable us to service any customer requirement.

Data use limitation
General research use
Data use requirements
Project-specific restrictions
Data Controller
University Hospitals Birmingham NHS Foundation Trust

Dataset Types: Health and disease, Treatments/Interventions

Dataset Sub-types: Cardiovascular


Collection Sources: Secondary care - In-patients