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released: 22 Dec 2011 author: AIHW

Acute coronary syndrome (ACS) refers to the spectrum of acute coronary artery diseases spanning acute myocardial infarction (AMI) and unstable angina (UA). They are sudden, severe and life-threatening events. This report reviews the current algorithm for monitoring the incidence of ACS in Australia, presenting a detailed analysis of hospitalisations for AMI and UA. It also presents a range of alternative algorithms for the estimation of ACS incidence. Further work is required to validate these algorithms.

ISBN 978-1-74249-273-5; Cat. no. CVD 57; 136pp.; Internet only

Full publication

Publication table of contents

  • Preliminary material
    • Contents
    • Acknowledgments
    • Abbreviations
    • Summary
  • Body section
    • 1 Introduction
      • 1.1 Background
      • 1.2 Objectives
      • 1.3 Structure of report
    • 2 Background
      • 2.1 What do we mean by acute coronary syndrome (ACS)?
        • Acute myocardial infarction
        • What is unstable angina?
      • 2.2 Why monitor ACS events on a national level?
      • 2.3 How do we currently monitor ACS events?
      • 2.4 Why review the current method of estimating ACS events?
    • 3 Data sources, codes and methods
      • 3.1 National Hospital Morbidity Database
        • Diagnosis codes for ACS events
      • 3.2 National Mortality Database
      • 3.3 Statistical methods
    • 4 Issues that impact on monitoring ACS events using national hospital data
      • 4.1 Changes to coding and coding standards
      • 4.2 Changes in diagnostic tests
      • 4.3 Changes in clinical practice
      • 4.4 Monitoring ACS rather than acute myocardial infarction
    • 5 Trends in hospitalisations for ACS
      • 5.1 Overview
        • Trends in acute myocardial infarction hospitalisations
          • Age and sex
          • Type of acute myocardial infarction
        • Trends in unstable angina hospitalisations
          • Age and sex
        • Trends in chest pain hospitalisations
      • 5.2 Length of stay
        • Length of stay for acute myocardial infarction hospitalisations
        • Length of stay for unstable angina hospitalisations
        • Length of stay for chest pain hospitalisations
      • 5.3 Urgency of admission

       

      • 5.4 Transfers
        • Transfers to another acute care hospital
          • Acute myocardial infarction
          • Unstable angina
          • Chest pain  
        • Transfers from another acute care hospital
          • Acute myocardial infarction
          • Unstable angina
          • Chest pain
      • 5.5 ACS hospitalisations ending in death

       

      • 5.6 Region of hospital
        • Transfers by region
        • Length of stay by region
        • Length of stay for transfers by region
      • 5.7 Procedures for ACS events
        • By length of stay
        • Transfers
        • Trends in procedure use
          
    • 6 Deaths

     

    • 7 Alternative algorithms
      • 7.1 Options for consideration
      • 7.2 ACS events
      • 7.3 Case-fatality
      • 7.4 Main points to note from the alternative algorithms
    • 8 Discussion and recommendations
      • Monitoring ACS events at a national level
      • The impact of change on national hospital data
      • Trends in deaths that affect the estimation of fatal ACS events
      • Alternative algorithms for estimating ACS events and case-fatality rates from existing administrative data
      • Further work required  
  • End matter
    • Appendix A: ICD-10-AM and ACHI codes
      • ICD-10-AM (6th edition) codes for AMI and unstable angina (UA)
        • I21 Acute myocardial infarction (AMI)
        • I22 Subsequent myocardial infarction
      • ACHI (ICD-10-AM 6th edition) codes for cardiac procedures
    • Appendix B: Statistical methods
      • Rates
      • Age-standardised rates
        • Direct age-standardisation
        • Population for standardisation
      • Totals
    • Appendix C: Detailed tables
      • Overview
      • Length of stay
      • Urgency of admission
      • Transfers
      • Deaths in hospital
      • Remoteness of hospital
      • Procedures
      • Deaths
    • Glossary
    • References
    • List of tables
    • List of figures

Recommended citation

AIHW 2011. Monitoring acute coronary syndrome using national hospital data: an information paper on trends and issues. Cat. no. CVD 57. Canberra: AIHW. Viewed 12 January 2013 <http://www.aihw.gov.au/publication-detail/?id=10737420977>.