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Acute coronary syndrome (clinical) DSS

Identifying and definitional attributes

Metadata item type:Help on this termData Set Specification
METeOR identifier:Help on this term319741
Registration status:Help on this termHealth, Superseded 01/10/2008
DSS type:Help on this termData Set Specification (DSS)
Scope:Help on this term

The collection of acute coronary syndrome core data (ACS-Data) is a voluntary data collection with individual hospitals or health service areas developing collection methods and policies appropriate for their service.

Acute coronary syndromes reflect the spectrum of coronary artery disease resulting in acute myocardial ischaemia, and span unstable angina, non-ST segment elevation myocardial infarction (NSTEMI) and ST-segment elevation myocardial infarction (STEMI). Clinically these diagnoses encompass a wide variation in risk, require complex and time urgent risk stratification and represent a large social and economic burden.

The definitions used in this data set specification are designed to underpin the data collected by health professionals in their day-to-day acute care practice. They relate to the realities of an acute clinical consultation for patients presenting with chest pain/ discomfort and the need to correctly identify, evaluate and manage patients at increased risk of a coronary event.

The data elements specified in this metadata set provide a framework for:

  1. promoting the delivery of evidenced-based acute coronary syndrome management care to patients;
  2. facilitating the ongoing improvement in the quality and safety of acute coronary syndrome management in acute care settings in Australia and New Zealand;
  3. improving the epidemiological and public health understanding of this syndrome; and
  4. supporting acute care services as they develop information systems to complement the above.

This is particularly important as the scientific evidence supporting the development of the data elements within the ACS data set specification indicate that accurate identification of the evolving myocardial infarction patient or the high/intermediate risk patient leading to the implementation of the appropriate management pathway impacts on the patient's outcome. Having a nationally recognised set of definitions in relation to defining a patient's diagnosis, risk status and outcomes is a prerequisite to achieving the above aims.

The ACS data set specification is based on the American College of Cardiology (ACC) Data Set for Acute Coronary Syndrome as published in the Journal of the American College of Cardiology in December 2001 (38:2114-30) as well as more recent scientific evidence around the diagnosis of myocardial infarction. The data elements are alphabetically listed and grouped in a similar manner to the American College of Cardiology's data set format. These features of the Australian ACS data set should ensure that the data is internationally comparable.

The data elements described here have been identified as high priority for inclusion in the NHDD for the collection of data relating to ACS management, along with supporting elements already existing within the NHDD (as listed). It is recommended that other data elements be collected as best practice - however, these are not listed here, as they are considered to be of a secondary priority. Such data elements include date of Coronary Artery Bypass Grafting (CABG), Percutaneous Coronary Intervention (PCI) and diagnostic cardiac catheterisation/angiography and recording the number of units of blood transfused.

However, the working group will approach the Australian Institute of Health and METeOR website.

Many of the data elements in this data set specification may also be used in the collection of other cardiovascular clinical information.

Where appropriate, it may be useful if the data definitions in this data set specification were used to address data definition needs in non-clinical environments such as public health surveys etc. This could allow for qualitative comparisons between data collected in, and aggregated from, clinical settings (i.e. using application of the ACS data set specification), with that collected through other means (e.g. public health surveys, reports).

A set of core ACS data elements and standardised definitions can inform the development and conduct of future registries at both the national and local level.

The working group formed under the National Heart Foundation of Australia (NHFA) and the Cardiac Society of Australia and New Zealand (CSANZ) initiative was diverse and included representation from the following organizations: the NHFA, the CSANZ, the Australasian College of Emergency Medicine, the Australian Institute of Health and Welfare, the Australasian Society of Cardiac & Thoracic Surgeons, Royal Australian College of Physicians (RACP), RACP - Towards a Safer Culture, National Centre for Classification in Health (Brisbane), the NSW Aboriginal Health & Medical Research Council, the George Institute for International Health, the School of Population Health at the University of Western Australia and the National Cardiovascular Monitoring System Advisory Committee.

To ensure the broad acceptance of the data set, the working group also sought consultation from the heads of cardiology departments, other specialist professional bodies and regional key opinion leaders in the field of acute coronary syndromes.

Collection and usage attributes

Collection methods:Help on this termThis data set specification is primarily concerned with the clinical use of ACS-Data. Acute care environments such as hospital emergency departments, coronary care units or similar acute care areas are the settings in which implementation of the core ACS data set specification should be considered. A wider range of health and health related establishments that create, use or maintain, records on health care clients, could also use it.

Relational attributes

Related metadata references:Help on this term

Supersedes Acute coronary syndrome (clinical) DSS Health, Superseded 07/12/2005

Metadata items in this Data Set SpecificationHelp on this term

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Seq No.Help on this termMetadata itemHelp on this term ObligationHelp on this term Max occursHelp on this term
-Episode of admitted patient care—separation date, DDMMYYYYMandatory1
-Episode of admitted patient care—separation mode, code NMandatory1
-Health service event—presentation date, DDMMYYYYMandatory1
-Health service event—presentation time, hhmmMandatory1
-Health service event—referral to rehabilitation service date, DDMMYYYYMandatory1
-Laboratory standard—upper limit of normal range for creatine kinase myocardial band isoenzyme, index code X[XXX]Mandatory1
-Laboratory standard—upper limit of normal range for creatine kinase myocardial band isoenzyme, percentage N[NNN]Mandatory1
-Laboratory standard—upper limit of normal range for creatine kinase myocardial band isoenzyme, total international units N[NNN]Optional1
-Laboratory standard—upper limit of normal range for creatine kinase myocardial band isoenzyme, total kCat per litre N[NNN]Optional1
-Laboratory standard—upper limit of normal range for creatine kinase myocardial band isoenzyme, total micrograms per litre N[NNN]Optional1
-Laboratory standard—upper limit of normal range for creatine kinase myocardial band isoenzyme, total nanograms per decilitre N[NNN]Conditional1
-Laboratory standard—upper limit of normal range for troponin assay, total micrograms per litre N[NNN]Optional1
-Non-admitted patient emergency department service episode—triage category, code NOptional1
-Non-admitted patient emergency department service episode—triage date, DDMMYYYYMandatory1
-Non-admitted patient emergency department service episode—triage time, hhmmMandatory1
-Non-admitted patient emergency department service episode—type of visit to emergency department, code NMandatory1
-Person—acute coronary syndrome concurrent clinical condition, code NNMandatory1
-Person—acute coronary syndrome procedure type, code NNMandatory1
-Person—acute coronary syndrome risk stratum, code NMandatory1
-Person—angiotensin converting enzyme inhibitors therapy status, code NNMandatory1
-Person—aspirin therapy status, code NNMandatory1
-Person—beta-blocker therapy status, code NNMandatory1
-Person—bleeding episode status, code NMandatory1
-Person—blood pressure (diastolic) (measured), millimetres of mercury NN[N]Mandatory1
-Person—blood pressure (systolic) (measured), millimetres of mercury NN[N]Mandatory1
-Person—chest pain pattern, code NMandatory1
-Person—cholesterol level (measured), total millimoles per litre N[N].NMandatory1
-Person—clinical evidence status (chronic lung disease), code NMandatory1
-Person—clinical evidence status (heart failure), code NMandatory1
-Person—clinical evidence status (peripheral arterial disease), code NMandatory1
-Person—clinical evidence status (sleep apnoea syndrome), code NMandatory1
-Person—clinical evidence status (stroke), code NMandatory1
-Person—clinical procedure timing, code NConditional1
-Person—clopidogrel therapy status, code NNMandatory1
-Person—country of birth, code (SACC 1998) NNNNMandatory1
-Person—creatine kinase myocardial band isoenzyme level (measured), index code X[XXX]Mandatory1
-Person—creatine kinase myocardial band isoenzyme level (measured), percentage N[NNN]Mandatory1
-Person—creatine kinase myocardial band isoenzyme level (measured), total kCat per litre N[NNN]Optional1
-Person—creatine kinase myocardial band isoenzyme level (measured), total nanograms per decilitre N[NNN]Optional1
-Person—creatine kinase myocardial band isoenzyme measured date, DDMMYYYYOptional1
-Person—creatine kinase myocardial band isoenzyme measured time, hhmmOptional1
-Person—creatine kinase-myocardial band isoenzyme level (measured), total international units N[NNN]Mandatory1
-Person—creatine kinase-myocardial band isoenzyme level (measured), total micrograms per litre N[NNNN]Optional1
-Person—creatinine serum level, micromoles per litre NN[NN]Optional1
-Person—date of birth, DDMMYYYYMandatory1
-Person—diabetes mellitus status, code NNMandatory1
-Person—electrocardiogram change location, code NConditional1
-Person—electrocardiogram change type, code NMandatory1
-Person—fibrinolytic drug administered, code NMandatory1
-Person—fibrinolytic therapy status, code NNMandatory1
-Person—first angioplasty balloon inflation or stenting date, DDMMYYYYConditional0
-Person—first angioplasty balloon inflation or stenting time, hhmmMandatory1
-Person—functional stress test element, code NMandatory1
-Person—functional stress test ischaemic result, code NMandatory1
-Person—glycoprotein IIb/IIIa receptor antagonist status, code NNMandatory1
-Person—heart rate, total beats per minute N[NN]Mandatory1
-Person—heart rhythm type, code N[N]Mandatory1
-Person—height (self-reported), total centimetres NN[N]Mandatory1
-Person—high-density lipoprotein cholesterol level (measured), total millimoles per litre [N].NNMandatory1
-Person—Indigenous status, code NMandatory1
-Person—intravenous fibrinolytic therapy date, DDMMYYYYMandatory1
-Person—intravenous fibrinolytic therapy time, hhmmMandatory1
-Person—Killip classification, code NMandatory1
-Person—lipid-lowering therapy status, code NNMandatory1
-Person—low-density lipoprotein cholesterol level (calculated), total millimoles per litre N[N].NMandatory1
-Person—myocardial infarction (history), code NMandatory1
-Person—person identifier, XXXXXX[X(14)]Mandatory1
-Person—premature cardiovascular disease family history status, code NMandatory1
-Person—reason for readmission following acute coronary syndrome episode, code N[N]Mandatory1
-Person—sex, code NMandatory1
-Person—tobacco smoking status, code NMandatory1
-Person—triglyceride level (measured), total millimoles per litre N[N].NMandatory1
-Person—troponin assay type, code NMandatory1
-Person—troponin level (measured), total micrograms per litre NN.NNMandatory1
-Person—troponin level measured date, DDMMYYYYMandatory1
-Person—troponin level measured time, hhmmMandatory1
-Person—vascular condition status (history), code NNMandatory1
-Person—weight (self-reported), total kilograms NN[N]Mandatory1
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