Identifying Hypertension in Pregnancy using Electronic Medical Records: The importance of Blood Pressure Values
| Autor: | Aruna Kamineni, Mary Akosile, Sascha Dublin, Rod L. Walker, Kristi Reynolds, Victoria L. Holt, Sylvia E. Badon, T. Craig Cheetham, Romain Neugebauer, Thomas R. Easterling, Nerissa Nance, Susan M. Shortreed, Lyndsay A. Avalos, Lu Chen, Zoe Bider-Canfield |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Hypertension in Pregnancy Pregnancy Complications Cardiovascular 030204 cardiovascular system & hematology Drug Prescriptions Article Cohort Studies 03 medical and health sciences 0302 clinical medicine Pregnancy Internal Medicine Medicine Electronic Health Records Humans Antihypertensive Agents Retrospective Studies 030219 obstetrics & reproductive medicine business.industry Obstetrics Delivery of Health Care Integrated Medical record Obstetrics and Gynecology Retrospective cohort study Hypertension Pregnancy-Induced medicine.disease United States Blood pressure Hypertension Gestation Female Diagnosis code business Cohort study |
| Zdroj: | Pregnancy Hypertens |
| Popis: | Objective To incorporate blood pressure (BP), diagnoses codes, and medication fills from electronic medical records (EMR) to identify pregnant women with hypertension. Study design A retrospective cohort study of singleton pregnancies at three US integrated health delivery systems during 2005–2014. Main outcome measures Women were considered hypertensive if they had any of the following: (1) ≥2 high BPs (≥140/90 mmHg) within 30 days during pregnancy (High BP); (2) an antihypertensive medication fill in the 120 days before pregnancy and a hypertension diagnosis from 1 year prior to pregnancy through 20 weeks gestation (Treated Chronic Hypertension); or (3) a high BP, a hypertension diagnosis, and a prescription fill within 7 days during pregnancy (Rapid Treatment). We described characteristics of these pregnancies and conducted medical record review to understand hypertension presence and severity. Results Of 566,624 pregnancies, 27,049 (4.8%) met our hypertension case definition: 24,140 (89.2%) with High BP, 5,409 (20.0%) with Treated Chronic Hypertension, and 5,363 (19.8%) with Rapid Treatment (not mutually exclusive). Of hypertensive pregnancies, 19,298 (71.3%) received a diagnosis, 9,762 (36.1%) received treatment and 11,226 (41.5%) had a BP ≥ 160/110. In a random sample (n = 55) of the 7,559 pregnancies meeting the High BP criterion with no hypertension diagnosis, clinical statements about hypertension were found in medical records for 58% of them. Conclusion Incorporating EMR BP identified many pregnant women with hypertension who would have been missed by using diagnosis codes alone. Future studies should seek to incorporate BP to study treatment and outcomes of hypertension in pregnancy. |
| Databáze: | OpenAIRE |
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