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Author Topic: Which conditions caused the most ACS admissions?  (Read 46 times)

Laxmikant Tyagi

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Which conditions caused the most ACS admissions?
« on: October 07, 2015, 08:39:56 am »
Which conditions caused the most ACS admissions?
Laxmikant Tyagi

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Harald Braun

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Re: Which conditions caused the most ACS admissions?
« Reply #1 on: October 07, 2015, 08:44:41 am »
There were marked differences in the rates at which emergency ACS admissions occurred, both between the broad categories and between individual conditions. These differences are demonstrated in Figure 3.2 (see page 12), where each condition is represented by a box proportional in width to its admission rate. Boxes are arranged vertically by descending contribution to the total admission rate for each ACS type. For example, COPD has a relatively wide box because it had a high admission rate, and is placed near the top because it contributed 24 per cent of all chronic ACS admissions. Dehydration has a narrow box due to its much lower admission rate, and is placed near the bottom with a cluster of conditions that, when combined, contributed fewer than 10 per cent of all acute ACS admissions. The top row shows the admission rates for each of the three ACS categories.

In 2012/13, the vast majority (86 per cent) of ACS admissions were caused by acute and chronic conditions rather than the third category of ACS: other and vaccine-preventable conditions. Five individual ACS conditions accounted for more than half of all ACS admissions. These were urinary tract infection (UTI) and pyelonephritis (16 per cent of ACS admissions, 229 admissions per 100,000), COPD (12 per cent, 163 per 100,000), pneumonia (10 per cent, 141 per 100,000), ear, nose and throat (ENT) infections (9 per cent, 207 per 100,000) and convulsions and epilepsy (7 per cent, 142 per 100,000).

While 27 ACS conditions are specified under the most common definition, it is clear from Figure 3.2 that the majority of these conditions (15) contributed a combined total of fewer than 10 per cent of all ACS admissions. While many of the less common conditions might not seem sufficiently prevalent to be of interest, in some areas they will be of greater concern than others (for example, tuberculosis in London). It is notable that three out of the five most common conditions disproportionately affect older people. In total, 40 per cent of all emergency admissions were for patients aged 65 and over, and this proportion rose to 50 per cent when considering only the ACS admissions. However, COPD, pneumonia and
UTI/pyelonephritis had 75 per cent, 70 per cent and 63 per cent of their admissions for older people, respectively.

The other two of the most common conditions disproportionately affect children and young adults (ENT infections, and epilepsy and convulsions). However, when considering all ACS admissions, half were for patients aged 65 and over, whereas ust 19 per cent were for the under-20s. This confirms that potentially avoidable emergency admission is an issue that predominantly – but not exclusively – affects older people.

For more information visit: http://www.nuffieldtrust.org.uk/sites/files/nuffield/publication/131010_qualitywatch_focus_preventable_admissions_0.pdf
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