The work detailed here is in relation to the following publication,
Using Routinely Collected Electronic Healthcare Record Data to Investigate Fibrotic Multimorbidity in England DOI: https://doi.org/10.2147/CLEP.S463499
Background: Electronic healthcare records (EHRs) are used to document diagnoses, symptoms, tests, and prescriptions. Though not primarily collected for research purposes, owing to the size of the data as well as the depth of information collected, they have been used extensively to conduct epidemiological research. The Clinical Practice Research Datalink (CPRD) is an EHR database containing representative data of the UK population with regard to age, sex, race, and social deprivation measures. Fibrotic conditions are characterised by excessive scarring, contributing towards organ dysfunction and eventual organ failure. Fibrosis is associated with ageing as well as many other factors, it is hypothesised that fibrotic conditions are caused by the same underlying pathological mechanism. We calculated the prevalence of fibrotic conditions (as defined in a previous Delphi survey of clinicians) as well as the prevalence of fibrotic multimorbidity (the proportion of people with multiple fibrotic conditions). Methods: We included a random sample of 993,370 UK adults, alive, and enrolled at a UK general practice, providing data to the CPRD Aurum database as of 1st of January 2015. Individuals had to be eligible for linkage to hospital episode statistics (HES) and ONS death registration. We calculated the point prevalence of fibrotic conditions and multi-morbid fibrosis on the 1st of January 2015. Using death records of those who died in 2015, we investigated the prevalence of fibrosis associated death. We explored the most commonly co-occurring fibrotic conditions and determined the settings in which diagnoses were commonly made (primary care, secondary care or after death). Results: The point prevalence of any fibrotic condition was 21.46%. In total, 6.00% of people had fibrotic multimorbidity. Of the people who died in 2015, 34.82% had a recording of a fibrotic condition listed on their death certificate. Conclusion: The key finding was that fibrotic multimorbidity affects approximately 1 in 16 people.
In addition to the published manuscript and supplementary materials I would like to provide the below table which demonstrates the location fibrotic conditions were diagnosed, this table explicitly uses the information of people who had died. Therefore, it differs from Supplementary table 3 which contains the locations fibrotic conditions were diagnosed in the total cohort, however as this contained people who were still alive it is believed that the information presented in Figure 2is more representative of the proportion of people who receive diagnoses (alowing for people to be diagnosed post mortem).
| Fibrotic Condition | Location | Percentage |
|---|---|---|
| Atherosclerosis | GP | 1.54 |
| Atherosclerosis | Hospital | 97.11 |
| Atherosclerosis | DeathCert | 1.34 |
| Biliary | GP | 8.83 |
| Biliary | Hospital | 73.22 |
| Biliary | DeathCert | 17.95 |
| BloodVessel | GP | 50.65 |
| BloodVessel | Hospital | 25.25 |
| BloodVessel | DeathCert | 24.09 |
| Cardiomyopathy | GP | 8.9 |
| Cardiomyopathy | Hospital | 10.6 |
| Cardiomyopathy | DeathCert | 80.5 |
| Diabetes | GP | 89.62 |
| Diabetes | Hospital | 7.49 |
| Diabetes | DeathCert | 2.89 |
| Integumentary | GP | 73.18 |
| Integumentary | Hospital | 16.82 |
| Integumentary | DeathCert | 10 |
| Intest-Panc | GP | 6.72 |
| Intest-Panc | Hospital | 86.31 |
| Intest-Panc | DeathCert | 6.98 |
| Liver | GP | 18.07 |
| Liver | Hospital | 56.39 |
| Liver | DeathCert | 25.54 |
| Lymphatic | GP | 15.95 |
| Lymphatic | Hospital | 4.65 |
| Lymphatic | DeathCert | 79.4 |
| Peritoneum | GP | 2.33 |
| Peritoneum | Hospital | 37.21 |
| Peritoneum | DeathCert | 60.47 |
| Pulmonary | GP | 5.68 |
| Pulmonary | Hospital | 12.26 |
| Pulmonary | DeathCert | 82.06 |
| Reproductive | GP | 13.82 |
| Reproductive | Hospital | 85.37 |
| Reproductive | DeathCert | 0.81 |
| Skeletal | GP | 67.45 |
| Skeletal | Hospital | 17.99 |
| Skeletal | DeathCert | 14.57 |
| Systemic | GP | 38.95 |
| Systemic | Hospital | 49.47 |
| Systemic | DeathCert | 11.58 |
| Urinary tract | GP | 28.38 |
| Urinary tract | Hospital | 56.32 |
| Urinary tract | DeathCert | 15.3 |
| Valve | GP | 29.52 |
| Valve | Hospital | 58.94 |
| Valve | DeathCert | 11.55 |