TY - JOUR
T1 - The use of automated data extraction tools to develop a solid organ transplant registry
T2 - Proof of concept study of bloodstream infections
AU - La Hoz, Ricardo M.
AU - Liu, Terrence
AU - Xie, Donglu
AU - Adams-Huet, Beverley
AU - Willett, Du Wayne L.
AU - Haley, Robert W.
AU - Greenberg, David E.
N1 - Funding Information:
The authors thank the patients of UT Southwestern Medical Center for helping us improve care through the use of information collected via our electronic health record system. This work was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health [ KL2TR001103 ]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Publisher Copyright:
© 2020 The British Infection Association
PY - 2021/1
Y1 - 2021/1
N2 - Background: We created an electronic health record-based registry using automated data extraction tools to study the epidemiology of bloodstream infections (BSI) in solid organ transplant recipients. The overarching goal was to determine the usefulness of an electronic health record-based registry using data extraction tools for clinical research in solid organ transplantation. Methods: We performed a retrospective single-center cohort study of adult solid organ transplant recipients from 2010 to 2015. Extraction tools were used to retrieve data from the electronic health record, which was integrated with national data sources. Electronic health records of subjects with positive blood cultures were manually adjudicated using consensus definitions. One-year cumulative incidence, risk factors for BSI acquisition, and 1-year mortality were analyzed by Kaplan–Meier method and Cox modeling, and 30-day mortality with logistic regression. Results: In 917 solid organ transplant recipients the cumulative incidence of BSI was 8.4% (95% confidence interval 6.8–10.4) with central line-associated BSI as the most common source. The proportion of multidrug-resistant isolates increased from 0% in 2010 to 47% in 2015 (p = 0.03). BSI was the strongest risk factor for 1-year mortality (HR=8.44; 4.99–14.27; p<0.001). In 11 of 14 deaths, BSI was the main cause or contributory in patients with non-rapidly fatal underlying conditions. Conclusions: Our study illustrates the usefulness of an electronic health record-based registry using automated extraction tools for clinical research in the field of solid organ transplantation. A BSI reduces the 1-year survival of solid organ transplant recipients. The most common sources of BSIs in our studies are preventable.
AB - Background: We created an electronic health record-based registry using automated data extraction tools to study the epidemiology of bloodstream infections (BSI) in solid organ transplant recipients. The overarching goal was to determine the usefulness of an electronic health record-based registry using data extraction tools for clinical research in solid organ transplantation. Methods: We performed a retrospective single-center cohort study of adult solid organ transplant recipients from 2010 to 2015. Extraction tools were used to retrieve data from the electronic health record, which was integrated with national data sources. Electronic health records of subjects with positive blood cultures were manually adjudicated using consensus definitions. One-year cumulative incidence, risk factors for BSI acquisition, and 1-year mortality were analyzed by Kaplan–Meier method and Cox modeling, and 30-day mortality with logistic regression. Results: In 917 solid organ transplant recipients the cumulative incidence of BSI was 8.4% (95% confidence interval 6.8–10.4) with central line-associated BSI as the most common source. The proportion of multidrug-resistant isolates increased from 0% in 2010 to 47% in 2015 (p = 0.03). BSI was the strongest risk factor for 1-year mortality (HR=8.44; 4.99–14.27; p<0.001). In 11 of 14 deaths, BSI was the main cause or contributory in patients with non-rapidly fatal underlying conditions. Conclusions: Our study illustrates the usefulness of an electronic health record-based registry using automated extraction tools for clinical research in the field of solid organ transplantation. A BSI reduces the 1-year survival of solid organ transplant recipients. The most common sources of BSIs in our studies are preventable.
KW - Bloodstream infections
KW - Electronic databases
KW - Epidemiology
KW - Informatics
KW - Solid organ transplant recipients
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U2 - 10.1016/j.jinf.2020.10.003
DO - 10.1016/j.jinf.2020.10.003
M3 - Article
C2 - 33038385
AN - SCOPUS:85092518665
SN - 0163-4453
VL - 82
SP - 41
EP - 47
JO - Journal of Infection
JF - Journal of Infection
IS - 1
ER -