NHS Information Authority

Data Standards Programme

As part of the Coronary Heart Disease Information Strategy, the NHS Information Authority is working with clinical communities to develop an outputs specification for CHD clinical information systems. As an early win to support this work, four initial clinical Data Sets were developed by the professional bodies and approval was sought from the NHS Information Standards Board. The first of the four data sets has been approved, and this DSCN makes changes to the NHS Data Dictionary Version.2 to support the first of the four Data Sets.

The Myocardial Infarction National Audit Project (MINAP) run by the Royal College of Physicians (RCP) has produced a Data Set to carry out a nationwide audit of Acute Myocardial Infarction (AMI). The project is a response to the audit requirements of the National Service Framework for Coronary Heart Disease (NSF - CHD) and provides the basis to monitor the standards for care of Acute Myocardial Infarction (AMI) established by the NSF - CHD:

Standard 5
People with symptoms of a possible heart attack should receive help from an individual equipped with and appropriately trained in the use of a defibrillator within eight minutes of calling for help, to maximise the benefits of resuscitation, should it be necessary.

Standard 6
People thought to be suffering from a heart attack, should be assessed professionally and, if indicated, receive aspirin. Thrombolysis should be given within 60 minutes of calling for professional help.

Standard 7
NHS Trusts should put in place agreed protocols/systems of care so that people admitted to hospital with proven heart attack are appropriately assessed and offered treatments of proven clinical cost effectiveness to reduce their risk of disability and death.

The Data Set will be maintained within the Central Cardiac Audit Database (CCAD).

ACUTE MYOCARDIAL INFARCTION CARE SPELL

Attributes of this Class are:

		AMI ADMISSION DIAGNOSIS
		AMI ADMISSION WARD TYPE
		AMI ADMITTING CONSULTANT TYPE
	O	AMI CAUSE OF DEATH IN HOSPITAL
	O	AMI DISCHARGE DIAGNOSIS
		AMI HEART RATE
	O	ANGIOGRAM DATE
		ARRIVAL AT HOSPITAL TIME
		BLEED COMPLICATION
	O	CORONARY ANGIOGRAPHY DATE
		CORONARY ANGIOGRAPHY PERFORMED
		CORONARY INTERVENTION PERFORMED
		ECG DETERMINING TREATMENT
		INITIAL CONTACT TYPE
		INVESTIGATION OR INTERVENTION REFERRAL DATE
	O	INVESTIGATION TRANSFER DATE
	O	REHABILITATION REFERRAL

ACUTE MYOCARDIAL INFARCTION CARE SPELL

This class has no relationships. Each ACUTE MYOCARDIAL INFARCTION CARE SPELL

may be associated with one or more AMI DISCHARGE DRUG

AMI DISCHARGE DRUG

AMI DISCHARGE DRUG

Identifies the AMI drug considered for treatment of the patient when discharged from hospital as part of the ACUTE MYOCARDIAL INFARCTION CARE SPELL.

This class is also known by these names:

Context	Alias
plural	AMI DISCHARGE DRUGS

Attributes of this Class are:

K		AMI DRUG TYPE
		DISCHARGED ON INDICATOR

Each AMI DISCHARGE DRUG

K	must be prescribed as part of one and only one ACUTE MYOCARDIAL INFARCTION CARE SPELL

ASPIRIN THERAPY

Attributes of this Class are:

		ASPIRIN THERAPY DETAIL
		ASPIRIN THERAPY LOCATION

BLOOD PRESSURE

BLOOD PRESSURE

A type of PERSON OBSERVATION.

A record of the person's blood pressure.

This class is also known by these names:

Context	Alias
plural	BLOOD PRESSURE

Attributes of this Class are:

		DIASTOLIC PRESSURE
		SYSTOLIC PRESSURE

This class has no relationships.

HOSPITAL SITE

Attributes of this Class are:

	O	CCAD HOSPTIAL IDENTIFIER
		DELIVERY FACILITIES AVAILABLE
	O	HIGH SECURITY PSYCHIATRIC ACCOMMODATION
		if approved high security accommodation provided on the hospital site
	O	HOSPITAL SITE TOTAL BEDS
		if not NHS site

PATIENT

Each PATIENT

	may be absent for one or more ABSENCE WITHOUT LEAVE
	may be related to one or more ACCIDENT AND EMERGENCY EPISODE
	may be associated with one or more CLINICAL INTERVENTION
	may be related to one or more COMMUNITY EPISODE
	may be the subject of one or more CONSULTANT EPISODE (ACUTE HOME-BASED)
	may be related to one or more CONSULTANT OUT-PATIENT EPISODE
	may be related to one or more DECISION TO ADMIT
	may be related to one or more DENTAL EPISODE
	may be related to one DISABLEMENT APPLIANCE
	may be related to one or more DISABLEMENT APPLIANCE REPAIR
	may be in receipt of one or more DISPENSED ITEM
	may be related to one or more DOMICILIARY CONSULTATION
	may be related to one or more ELECTIVE ADMISSION LIST ENTRY
	may be related to one or more EMERGENCY DENTAL ATTENDANCE
	may be related to one or more FACE TO FACE CONTACT DENTAL
	may be the subject of one or more FACE TO FACE CONTACT OPTICAL
	may be related to one or more GENITO-URINARY EPISODE
	may be related to one or more HOME DIALYSIS EPISODE
	may be related to one or more HOME LEAVE
	may be the subject of one or more HONOS SCORE FOR PERSON
	may be related to one or more HOSPITAL PROVIDER SPELL
	may be granted leave for one or more LEAVE OF ABSENCE
	may be related to one or more LEGAL STATUS
	may be related to one or more LITHOTRIPSY COURSE ATTENDANCE
	may be related to one or more MATERNITY DOMICILIARY VISIT
	may be subject to one or more MENTAL HEALTH CARE SPELL
	may be related to one or more MIDWIFE EPISODE
	may be related to one or more NURSING EPISODE
	may be related to one or more NURSING HOME STAY (MIDWIFE CARE)
	may be related to one or more NURSING HOME STAY (NURSING CARE)
	may be in receipt of health care services under one or more OUT OF AREA TREATMENT
	may be related to one or more OUT-PATIENT APPOINTMENT
	may be related to one or more PATIENT JOURNEY
	may be issued with one or more POWERED WHEELCHAIR
	may be related to one or more PREGNANCY EPISODE
	may be in receipt of one or more PRESCRIPTION
	may be related to one or more PROFESSIONAL STAFF GROUP EPISODE
	may be related to one or more RADIOTHERAPY TREATMENT COURSE
	may be related to one or more REFERRAL FOR BIOPSY
	may be related to one or more REFERRAL FOR BREAST ASSESSMENT
	may be related to one or more REFERRAL FOR BREAST TREATMENT
	may be related to one or more REFERRAL FOR SCREENING TEST
	may be related to one or more REFERRAL REQUEST
	may be related to one or more REGULAR ATTENDER EPISODE
	may be related to one or more REQUEST FOR DIAGNOSTIC TEST
	may be related to one or more RESIDENTIAL CARE OR GROUP HOME STAY
	may be the subject of one or more ROAD TRAFFIC ACCIDENT TREATMENT
	may be identified as needing one or more SECURE ACCOMMODATION REQUIREMENT
	may be related to one or more SERVICE REPORT HEADER
	may be related to one or more THEATRE CASE
	may be associated with one or more TOBACCO USAGE
	may be related to one or more WARD ATTENDANCE
	may be issued with one or more WHEELCHAIR SERVICES VOUCHER

PATIENT CLINICAL GROUP

PATIENT CLINICAL GROUP

A type of CHARACTERISTIC.

The patient's ethnic group as perceived by the clinician.

Note: PATIENT CLINICAL GROUP is the classification used for the patient's ethnic group as developed for the AMI Data Set.

National Codes:

01	Caucasian
02	Black
03	Asian
04	Oriental
08	Other

References:
Acute Myocardial Infarction Core Data Set Version 3.0

This class is also known by these names:

Context	Alias
plural	PATIENT CLINICAL GROUPS

This class has no attributes.

This class has no relationships.

PATIENT INITIATED AMI CARE SPELL

Attributes of this Class are:

		INITIAL PATIENT CONTACT DATE
		INITIAL PATIENT CONTACT TIME
		INITIAL PATIENT CONTACT TYPE

THERAPY AFTER DISCHARGE

This class has no attributes. Attributes of this Class are:

THERAPY TYPE

THROMBOLYTIC THERAPY

Attributes of this Class are:

		THROMBOLYTIC DRUG
		THROMBOLYTIC TREATMENT DELAY REASON
		THROMBOLYTIC TREATMENT NOT GIVEN REASON

TOBACCO USAGE

TOBACCO USAGE

The history of a PATIENT's tobacco usage.

References:
National Cancer Data Set Version 1.1_ISB October 2001
Acute Myocardial Infarction Core Data Set

This class is also known by these names:

Context	Alias
plural	TOBACCO USAGES

Attributes of this Class are:

K		START DATE
K		TOBACCO USAGE TYPE
	O	CIGARETTES PER DAY
		if current or ex-smoker
	O	DATE STOPPED SMOKING
		if ex-smoker
	O	NUMBER OF YEARS SMOKED
		if current or ex-smoker
		SMOKING STATUS
	O	TOBACCO CHEWING HISTORY

Each TOBACCO USAGE

K	must be the usage of one and only one PATIENT

AMI ADMISSION DIAGNOSIS

AMI ADMISSION DIAGNOSIS

This is a working diagnosis at the time of admission for an ACUTE MYOCARDIAL INFARCTION CARE SPELL. The primary purpose is to identify those patients who are admitted with a diagnosis of definite (ST elevation MI).

National Codes:

1	Definite myocardial infarction
2	Probable myocardial infarction
3	Acute coronary syndrome
4	Chest pain - query cause
5	Other initial diagnosis

References:
Acute Myocardial Infarction Core Data Set Version 3.0

This attribute is also known by these names:

Context	Alias
plural	AMI ADMISSION DIAGNOSES

AMI ADMISSION WARD TYPE

AMI ADMISSION WARD TYPE

The type of unit to which the PATIENT is admitted either from A&E or directly by the ambulance service and where the patient will spend the majority of the first 24 hours in hospital following an Acute Myocardial Infarction.

National Codes:

1	Cardiac Care Unit
2	Acute Admissions unit
3	General medical ward
4	Intensive therapy unit
5	Other
6	Died in A&E
7	Cardiac ward (non-Cardiac Care Unit)
8	Stepdown ward

References:
Acute Myocardial Infarction Core Data Set Version 3.0

This attribute is also known by these names:

Context	Alias
plural	AMI ADMISSION WARD TYPES

AMI ADMITTING CONSULTANT TYPE

AMI ADMITTING CONSULTANT TYPE

The type of clinician having primary rather than advisory care of the patient immediately (first 24 hours) after admission to hospital (not the A&E consultant) following an Acute Myocardial Infarction.

National Codes:

0	Cardiologist
1	Other general physician
9	Other

References:
Acute Myocardial Infarction Core Data Set Version 3.0

This attribute is also known by these names:

Context	Alias
plural	AMI ADMITTING CONSULTANT TYPES

AMI DISCHARGE DIAGNOSIS

AMI DISCHARGE DIAGNOSIS

The acute myocardial infarction diagnosis at discharge.

National codes:

01	Myocardial infarction (ST elevation)
02	Myocardial infarction (non ST elevation)
03	Threatened Myocardial Infarction
04	Acute coronary syndrome (troponin positive)
05	Acute coronary syndrome (troponin negative)
10	Acute coronary syndrome (troponin unspecified)
06	Chest pain of uncertain cause
07	Myocardial infarction (unconfirmed)
08	Other diagnosis

Note: The classification has been listed in logical sequence rather than alphanumeric order.

References:
Acute Myocardial Infarction Core Data Set Version 3.0

This attribute is also known by these names:

Context	Alias
plural	AMI DISCHARGE DIAGNOSES

AMI DRUG TYPE

AMI DRUG TYPE

The AMI drug considered for treatment of the PATIENT when discharged from hospital as part of an ACUTE MYOCARDIAL INFARCTION CARE SPELL.

Classification:

a.	Beta Blocker
b.	Angiotensin Inhibitor
c.	Statin
d.	Aspirin
e.	Other anti-platelet agent

References:
Acute Myocardial Infarction Core Data Set Version 3.0

This attribute is also known by these names:

Context	Alias
plural	AMI DRUG TYPES

AMI HEART RATE

AMI HEART RATE

The heart rate recorded from the first ECG after admission to hospital, whilst in a stable cardiac rhythm i.e. sinus rhythm, or chronic AF. In complete heart block record ventricular rate. Where the presenting rhythm is a treatable tachyarrhythmia, the first stable heart rate after treatment should be used.

References:
Acute Myocardial Infarction Core Data Set Version 3.0

This attribute is also known by these names:

Context	Alias
plural	AMI HEART RATES

ANGIOGRAM DATE

ANGIOGRAM DATE

The date on which an angiogram is performed within the ACUTE MYOCARDIAL INFARCTION CARE SPELL.

This attribute is also known by these names:

Context	Alias
plural	ANGIOGRAM DATES

ARRIVAL AT HOSPITAL TIME

ARRIVAL AT HOSPITAL TIME

The time the patient arrived at the hospital.

Where the patient arrived in an ambulance this is the time of arrival of the ambulance at the front door as recorded by the ambulance service.

Where the patient is self referred, this is the time of registration in A&E.

References:
Acute Myocardial Infarction Core Data Set Version 3.0

This attribute is also known by these names:

Context	Alias
plural	ARRIVAL AT HOSPITAL TIMES

ASPIRIN THERAPY DETAIL

ASPIRIN THERAPY DETAIL

ASPIRIN THERAPY LOCATION

ASPIRIN THERAPY DETAIL

Provides information about the aspirin therapy given to a PATIENT.

National Codes:

1	Already on aspirin
2	Aspirin given out of hospital
3	Aspirin given after arrival in hospital
4	Clinical contraindication to aspirin (and no other antiplatelet agent used)
5	Either already on another antiplatelet agent or started on one because of clinical contraindications to aspirin
6	No antiplatelet agent used
7	On warfarin, aspirin not given
9	Not known
8	Not Given

References:
Acute Myocardial Infarction Core Data Set Version 2.8Acute Myocardial Infarction Core Data Set Version 3.0

This attribute is also known by these names:

Context	Alias
plural	ASPIRIN THERAPY DETAILS
plural	ASPIRIN THERAPY LOCATIONS

BLEED COMPLICATION

BLEED COMPLICATION

A record of the highest ranked bleed complication experienced by the PATIENT during the ACUTE MYOCARDIAL INFARCTION CARE SPELL. The list below is shown in order of preference and the highest item that applies should be recorded.

National Codes:

1	Intracranial bleed
2	Retroperitoneal bleed
3	Any other spontaneous bleed with Hb fall >=5g or Hct >15%
4	Bleed from any non-intracranial or non-retroperitoneal site with Hb fall >3g and <5g
5	Bleed from any non-intracranial or non-retroperitoneal site with Hb fall <=3g
6	None

References:
Acute Myocardial Infarction Core Data Set Version 3.0

This attribute is also known by these names:

Context	Alias
plural	BLEED COMPLICATIONS

CARDIAC ARREST OUTCOME

The outcome of the CARDIAC ARREST.

National Codes:

1	No return of circulation
2	Return of spontaneous circulation
2	Return of spontaneous circulation, but died in hospital
5	Resuscitation not attempted
3	Discharged from hospital (with neurological deficit)
9	Not known
4	Discharged from hospital (no neurological deficit)
5	Resuscitation not attempted

References:
Acute Myocardial Infarction Core Data Set Version 2.8Acute Myocardial Infarction Core Data Set Version 3.0

This attribute is also known by these names:

Context	Alias
plural	CARDIAC ARREST OUTCOMES

CARDIAC ARREST PRESENTING RHYTHM

The heart rhythm for the PATIENT at the time of the CARDIAC ARREST.

National Codes:

1	Asystole
2	Ventricular fibrillation/pulseless ventricular tachycardia
3	Electro mechanical disassociation
9	Not known

References:
Acute Myocardial Infarction Core Data Set Version 2.8Acute Myocardial Infarction Core Data Set Version 3.0

This attribute is also known by these names:

Context	Alias
plural	CARDIAC ARREST PRESENTING RHYTHMS

CCAD HOSPTIAL IDENTIFIER

CCAD HOSPTIAL IDENTIFIER

A unique identifier allocated to cardiac specialist hospitals and maintained in the Central Cardiac Audit Database (CCAD). A legacy identifier used within CCAD for identification and analysis of individual centre audit data.

This attribute is also known by these names:

Context	Alias
plural	CCAD HOSPTIAL IDENTIFIERS

CIGARETTES PER DAY

CIGARETTES PER DAY

The number of cigarettes smoked by the patient where they are a current or ex-smoker.

This attribute is also known by these names:

Context	Alias
plural	CIGARETTES PER DAY

CORONARY ANGIOGRAPHY DATE

CORONARY ANGIOGRAPHY DATE

The date on which a coronary angiography is performed with an ACUTE MYOCARDIAL INFARCTION CARE SPELL.

This attribute is also known by these names:

Context	Alias
plural	CORONARY ANGIOGRAPHY DATES

CORONARY ANGIOGRAPHY PERFORMED

CORONARY ANGIOGRAPHY PERFORMED

A record of the coronary angiography performed during an ACUTE MYOCARDIAL INFARCTION CARE SPELL.

National Codes:

1	Protocol driven investigation performed in the same hospital
2	Symptom driven investigation performed in the same hospital
3	Protocol driven investigation performed at another centre
4	Symptom driven investigation performed at another centre
5	Planned after discharge
8	Not performed

References:
Acute Myocardial Infarction Core Data Set Version 3.0

This attribute is also known by these names:

Context	Alias
plural	CORONARY ANGIOGRAPHIES PERFORMED

CORONARY INTERVENTION PERFORMED

CORONARY INTERVENTION PERFORMED

A record of the coronary intervention performed for recurrent symptoms or as an elective procedure during an ACUTE MYOCARDIAL INFARCTION CARE SPELL.

National Codes:

1	Angioplasty
2	CABG
3	Planned after discharge
8	Not performed

References:
Acute Myocardial Infarction Core Data Set Version 3.0

This attribute is also known by these names:

Context	Alias
plural	CORONARY INTERVENTIONS PERFORMED

DATE STOPPED SMOKING

DATE STOPPED SMOKING

The date on which the PATIENT stopped smoking where they are an ex-smoker. If the exact date is not known, then the year should be recorded.

This attribute is also known by these names:

Context	Alias
plural	DATES STOPPED SMOKING

DIASTOLIC PRESSURE

DIASTOLIC PRESSURE

The pressure reading of the blood between heart beats.

This attribute is also known by these names:

Context	Alias
plural	DIASTOLIC PRESSURE

DISCHARGED ON INDICATOR

DISCHARGED ON INDICATOR

Indicates if the PERSON was discharged from hospital on a particular AMI DISCHARGE DRUG

National codes:

0	No
1	Yes
2	Contraindicated
8	Not indicated

References:
Acute Myocardial Infarction Core Data Set Version 3.0

This attribute is also known by these names:

Context	Alias
plural	DISCHARGED ON INDICATORS

ECG DETERMINING TREATMENT

A classification of the electrocardiograph (ECG) reading that determined the treatment provided to a PATIENT in an ACUTE MYOCARDIAL INFARCTION CARE SPELL.

National Codes:

1	ST segment elevation
2	Left bundle branch block
3	ST segment depression
4	T wave changes only
5	Other abnormality
8	Not known
6	Normal ECG

References:
Acute Myocardial Infarction Core Data Set Version 2.8Acute Myocardial Infarction Core Data Set Version 3.0

This attribute is also known by these names:

Context	Alias
plural	ECG DETERMINING TREATMENTS

INITIAL PATIENT CONTACT TYPE

INITIAL PATIENT CONTACT TYPE

INITIAL CONTACT TYPE

INITIAL PATIENT CONTACT TYPE

Identifies the type of contact initially made by the PATIENT in relation to the acute myocardial infarction. Identifies the type of contact initially made by the PATIENT or other non-professional in attendance, in relation to the acute myocardial infarction.

National Codes:

1	Called GP who saw patient then called emergency services
2	Called GP who called emergency services then saw patient
3	Called emergency services
4	Called NHS Direct
5	Made own way to hospital (did not call anyone)
6	Called local helpline
7	Called GP, told to make own way to hospital
9	Not known
8	Patient already in hospital
9	Transferred for PCI/Surgery
10	Transferred for primary treatment

References:
Acute Myocardial Infarction Core Data Set Version 2.8Acute Myocardial Infarction Core Data Set Version 3.0

This attribute is also known by these names:

Context	Alias
plural	INITIAL PATIENT CONTACT TYPES
plural	INITIAL CONTACT TYPES

INVESTIGATION OR INTERVENTION REFERRAL DATE

INVESTIGATION OR INTERVENTION REFERRAL DATE

The date on which a referral for angiography and possible intervention was made, either within the same hospital or to another centre during an ACUTE MYOCARDIAL INFARCTION CARE SPELL.

This attribute is also known by these names:

Context	Alias
plural	INVESTIGATION OR INTERVENTION REFERRAL DATES

INVESTIGATION TRANSFER DATE

INVESTIGATION TRANSFER DATE

The date on which a transfer took place for an investigation and/or interventional treatment within the same hospital and during an ACUTE MYOCARDIAL INFARCTION CARE SPELL.

This attribute is also known by these names:

Context	Alias
plural	INVESTIGATION TRANSFER DATES

NUMBER OF YEARS SMOKED

NUMBER OF YEARS SMOKED

The number of years that a patient was smoking where they are a current or ex-smoker. This is used with the CIGARETTES PER DAY to calculate the estimated pack years of smoking.

This attribute is also known by these names:

Context	Alias
plural	NUMBER OF YEARS SMOKED

REHABILITATION REFERRAL

REHABILITATION REFERRAL

Referral to a rehabilitation service for the PATIENT either in hospital or after discharge from hospital.

National Codes:

0	No
1	Yes
2	Planned after discharge

References:
Acute Myocardial Infarction Core Data Set Version 3.0

This attribute is also known by these names:

Context	Alias
plural	REHABILITATION REFERRALS

REPERFUSION INITIAL DECISION

Classifies the type of clinician who took the initial decision to attempt REPERFUSION.

National Codes:

0	No reperfusion attempted
1	Specialist nurse
2	A&E clinician
3	Member of on-call medical team
4	Member of on-call cardiology team
9	Not known
5	GP
6	Paramedic

References:
Acute Myocardial Infarction Core Data Set Version 2.8Acute Myocardial Infarction Core Data Set Version 3.0

This attribute is also known by these names:

Context	Alias
plural	REPERFUSION INITIAL DECISIONS

REPERFUSION TREATMENT LOCATION

Classifies the location at which the initial REPERFUSION treatment was given.

National Codes:

0	No reperfusion attempted
1	Before admission to hospital
2	In A&E
3	In Coronary care unit (direct admission)
4	In Coronary care unit (slowtrack)
5	Elsewhere in hospital
9	Not known

References:
Acute Myocardial Infarction Core Data Set Version 2.8Acute Myocardial Infarction Core Data Set Version 3.0

This attribute is also known by these names:

Context	Alias
plural	REPERFUSION TREATMENT LOCATIONS

SMOKING STATUS

SMOKING STATUS

The smoking status of the PATIENT at the time the TOBACCO USAGE is recorded.

National Codes:

1	Current smoker
2	Ex-smoker
3	Non-smoker - history unknown
4	Never smoked
9	Unknown

References:
National Cancer Data Set Version 1.1_ISB October 2001
Acute Myocardial Infarction Core Data Set

This attribute is also known by these names:

Context	Alias
plural	SMOKING STATUSES

SYSTOLIC PRESSURE

SYSTOLIC PRESSURE

The pressure reading of the blood at each heart beat.

This attribute is also known by these names:

Context	Alias
plural	SYSTOLIC PRESSURE

THERAPY TYPE

THERAPY TYPE

The type of therapy that the patient will obtain following discharge from the HOSPITAL PROVIDER SPELL.

Classifications:

a.	Echocardiography
b.	Exercise test
c.	Radionuclide Study

This attribute is also known by these names:

Context	Alias
plural	THERAPY TYPES

THROMBOLYTIC DRUG

THROMBOLYTIC DRUG

The thrombolytic drug administered as the THROMBOLYTIC THERAPY.

National Codes:

1	Streptokinase
2	Alteplase
3	Reteplase
4	Tenecteplase

References:
Acute Myocardial Infarction Core Data Set Version 3.0

This attribute is also known by these names:

Context	Alias
plural	THROMBOLYTIC DRUGS

THROMBOLYTIC TREATMENT DELAY REASON

Identifies delay in the thrombolytic therapy and the reason for this.

National Codes:

1	Sustained hypertension
2	Clinical concern about recent cerebrovascular event or surgery
3	Delay obtaining consent
4	Initial ECG not diagnostic
5	Cardiac Arrest
9	Other

References:
Acute Myocardial Infarction Core Data Set Version 2.8Acute Myocardial Infarction Core Data Set Version 3.0

This attribute is also known by these names:

Context	Alias
plural	THROMBOLYTIC TREATMENT DELAY REASONS

THROMBOLYTIC TREATMENT NOT GIVEN REASON

Identifies the reason why thrombolytic treatment is not given for an acute myocardial infarction.

National Codes:

1	Ineligible ECG
2	Too late
3	Risk of haemorrhage
4	Uncontrolled hypertension
5	Administrative failure
6	Elective decision
9	Not known
7	Patient refused treatment
8	Other

References:
Acute Myocardial Infarction Core Data Set Version 2.8Acute Myocardial Infarction Core Data Set Version 3.0

This attribute is also known by these names:

Context	Alias
plural	THROMBOLYTIC TREATMENT NOT GIVEN REASONS

TOBACCO CHEWING HISTORY

TOBACCO CHEWING HISTORY

The PATIENT's history of tobacco chewing as part of their TOBACCO USAGE.

National Codes:

1	Current
2	Ex
3	Never
3	Unknown

References:
National Cancer Data Set Version 1.1_ISB October 2001

This attribute is also known by these names:

Context	Alias
plural	TOBACCO CHEWING HISTORY'S

TOBACCO USAGE TYPE

TOBACCO USAGE TYPE

The type of a PATIENT's TOBACCO USAGE.

National Codes:

G	Cigarettes
P	Pipe
W	Chewing

References:
National Cancer Data Set Version 1.1_ISB October 2001

This attribute is also known by these names:

Context	Alias
plural	TOBACCO USAGE TYPES

AMI ADMISSION DIAGNOSIS

AMI ADMISSION DIAGNOSIS

Format/length:	n1
HES item:
National Codes:	Press Definition button for the National Codes
Default Codes:

Notes:
This is a working diagnosis at the time of admission. The primary purpose is to identify those patients who are admitted with a diagnosis of definite (ST elevation MI). Do not change Admission diagnosis on the basis of further ECGs or enzymes/markers.

CCAD item name:
Admission Diagnosis

This data element is also known by these names:

Context	Alias
plural	AMI ADMISSION DIAGNOSES

AMI ADMISSION WARD TYPE

AMI ADMISSION WARD TYPE

Format/length:	n1
HES item:
National Codes:	Press Definition button for the National Codes
Default Codes:	9 - Unknown

Notes:
Refers to the unit to which the patient is admitted either from A&E or directly by ambulance service and where patient will spend majority of first 24 hours in hospital. If patient admitted direct to the catheter lab, enter facility to which patient admitted on leaving lab.

CCAD item name:
Admission Ward

This data element is also known by these names:

Context	Alias
plural	AMI ADMISSION WARD TYPES

AMI ADMITTING CONSULTANT TYPE

AMI ADMITTING CONSULTANT TYPE

Format/length:	n2
HES item:
National Codes:	Press Definition button for the National Codes
Default Codes:	99 - Unknown

Notes:
The clinician having primary rather than advisory care of the patient immediately (first 24 hours) after admission to hospital (not the A&E consultant).

CCAD item name:
Admitting Consultant

This data element is also known by these names:

Context	Alias
plural	AMI ADMITTING CONSULTANT TYPES

AMI CAUSE OF DEATH IN HOSPITAL

AMI CAUSE OF DEATH IN HOSPITAL

Format/length:	n1
HES item:
National Codes:
Default Codes:	0 - Not dead
	9 - Unknown

Notes:

CCAD item name:
Death in hospital

This data element is also known by these names:

Context	Alias
plural	AMI CAUSE OF DEATH IN HOSPITAL

AMI DISCHARGE DIAGNOSIS

AMI DISCHARGE DIAGNOSIS

Format/length:	n2
HES item:
National Codes:	Press Definition button for the National Codes
Default Codes:

Notes:

CCAD item name:
Discharge Diagnosis

This data element is also known by these names:

Context	Alias
plural	AMI DISCHARGE DIAGNOSES

AMI DRUG TREATMENT (ANGIOTENSIN II BLOCKER)

AMI DRUG TREATMENT (ANGIOTENSIN II BLOCKER)

Format/length:	n1
HES item:
National Codes:	0 - No
	1 - Yes
Default Codes:	9 - Unknown

Notes:
Derive from the patient DRUG TREATMENT and DRUG DOSAGE AND ADMINISTRATION within the ACUTE MYOCARDIAL INFARCTION CARE SPELL.

CCAD item name:
Angiotensin II Blocker (ARB)

This data element is also known by these names:

Context	Alias
plural	AMI DRUG TREATMENTS (ANGIOTENSIN II BLOCKER)

AMI DRUG TREATMENT (CALCIUM CHANNEL BLOCKER)

AMI DRUG TREATMENT (CALCIUM CHANNEL BLOCKER)

Format/length:	n1
HES item:
National Codes:	0 - No
	1 - Yes
Default Codes:	9 - Unknown

Notes:
Derive from the patient DRUG TREATMENT and DRUG DOSAGE AND ADMINISTRATION within the ACUTE MYOCARDIAL INFARCTION CARE SPELL.

CCAD item name:
Calcium channel blocker

This data element is also known by these names:

Context	Alias
plural	AMI DRUG TREATMENTS (CALCIUM CHANNEL BLOCKER)

AMI DRUG TREATMENT (IV 2B/3A AGENT)

AMI DRUG TREATMENT (IV 2b/3a AGENT)

Format/length:	n1
HES item:
National Codes:	0 - No
	1 - Yes
Default Codes:	9 -Unknown

Notes:
Derive from the patient DRUG TREATMENT and DRUG DOSAGE AND ADMINISTRATION within the ACUTE MYOCARDIAL INFARCTION CARE SPELL.

Excludes use of 2b/3a agents started during PCI.

CCAD item name:
IV 2b/3a AGENT

This data element is also known by these names:

Context	Alias
plural	AMI DRUG TREATMENTS (IV 2b/3a AGENT)

AMI DRUG TREATMENT (IV BETA BLOCKER)

AMI DRUG TREATMENT (IV BETA BLOCKER)

Format/length:	n1
HES item:
National Codes:	0 - No
	1 - Yes
Default Codes:	9 - Unknown

Notes:
Derive from the patient DRUG TREATMENT and DRUG DOSAGE AND ADMINISTRATION within the ACUTE MYOCARDIAL INFARCTION CARE SPELL.

CCAD item name:
IV beta blocker

This data element is also known by these names:

Context	Alias
plural	AMI DRUG TREATMENTS (IV BETA BLOCKER)

AMI DRUG TREATMENT (IV NITRATE)

AMI DRUG TREATMENT (IV NITRATE)

Format/length:	n1
HES item:
National Codes:	0 - No
	1 - Yes
Default Codes:	9 - Unknown

Notes:
Derive from the patient DRUG TREATMENT and DRUG DOSAGE AND ADMINISTRATION within the ACUTE MYOCARDIAL INFARCTION CARE SPELL.

CCAD item name:
IV Nitrate

This data element is also known by these names:

Context	Alias
plural	AMI DRUG TREATMENTS (IV NITRATE)

AMI DRUG TREATMENT (LOOP DIURETIC)

AMI DRUG TREATMENT (LOOP DIURETIC)

Format/length:	n1
HES item:
National Codes:	0 - No
	1 - Yes
Default Codes:	9 - Unknown

Notes:
Derive from the patient DRUG TREATMENT and DRUG DOSAGE AND ADMINISTRATION within the ACUTE MYOCARDIAL INFARCTION CARE SPELL.

Use when a diuretic drug is introduced or used in increased dose.

CCAD item name:
Loop diuretic

This data element is also known by these names:

Context	Alias
plural	AMI DRUG TREATMENTS (LOOP DIURETIC)

AMI DRUG TREATMENT (LOW MOLECULAR WEIGHT HEPARIN)

AMI DRUG TREATMENT (LOW MOLECULAR WEIGHT HEPARIN)

Format/length:	n1
HES item:
National Codes:	0 - No
	1 - Yes
Default Codes:	9 - Unknown

Notes:
Derive from the patient DRUG TREATMENT and DRUG DOSAGE AND ADMINISTRATION within the ACUTE MYOCARDIAL INFARCTION CARE SPELL.

Use of low molecular weight heparin as therapy for ACS or STE AMI either alone or in conjunction with other treatment.

CCAD item name:
Low molecular weight heparin

This data element is also known by these names:

Context	Alias
plural	AMI DRUG TREATMENTS (LOW MOLECULAR WEIGHT HEPARIN)

AMI DRUG TREATMENT (ORAL ANTI-PLATELET AGENT)

AMI DRUG TREATMENT (ORAL ANTI-PLATELET AGENT)

Format/length:	n1
HES item:
National Codes:	0 - No
	1 - Yes
Default Codes:	9 - Unknown

Notes:
Derive from the patient DRUG TREATMENT and DRUG DOSAGE AND ADMINISTRATION within the ACUTE MYOCARDIAL INFARCTION CARE SPELL.

For example - dipyridamole.

CCAD item name:
Other oral anti-platelet agent

This data element is also known by these names:

Context	Alias
plural	AMI DRUG TREATMENTS (ORAL ANTI-PLATELET AGENT)

AMI DRUG TREATMENT (ORAL NITRATE)

AMI DRUG TREATMENT (ORAL NITRATE)

Format/length:	n1
HES item:
National Codes:	0 - No
	1 - Yes
Default Codes:	9 - Unknown

Notes:
Derive from the patient DRUG TREATMENT and DRUG DOSAGE AND ADMINISTRATION within the ACUTE MYOCARDIAL INFARCTION CARE SPELL.

Does not include sublingual nitroglycerine or spray used on an as-needed basis.

CCAD item name:
Oral nitrate

This data element is also known by these names:

Context	Alias
plural	AMI DRUG TREATMENTS (ORAL NITRATE)

AMI DRUG TREATMENT (POTASSIUM CHANNEL MODULATOR)

AMI DRUG TREATMENT (POTASSIUM CHANNEL MODULATOR)

Format/length:	n1
HES item:
National Codes:	0 - No
	1 - Yes
Default Codes:	9 - Unknown

Notes:
Derive from the patient DRUG TREATMENT and DRUG DOSAGE AND ADMINISTRATION within the ACUTE MYOCARDIAL INFARCTION CARE SPELL.

CCAD item name:
Potassium channel modulator

This data element is also known by these names:

Context	Alias
plural	AMI DRUG TREATMENTS (POTASSIUM CHANNEL MODULATOR)

AMI DRUG TREATMENT (SPIRONOLACTONE)

AMI DRUG TREATMENT (SPIRONOLACTONE)

Format/length:	n1
HES item:
National Codes:	0 - No
	1 - Yes
Default Codes:	9 - Unknown

Notes:
Derive from the patient DRUG TREATMENT and DRUG DOSAGE AND ADMINISTRATION within the ACUTE MYOCARDIAL INFARCTION CARE SPELL.

CCAD item name:
Spironolactone

This data element is also known by these names:

Context	Alias
plural	AMI DRUG TREATMENTS (SPIRONOLACTONE)

AMI DRUG TREATMENT (THIAZIDE DIURETIC)

AMI DRUG TREATMENT (THIAZIDE DIURETIC)

Format/length:	n1
HES item:
National Codes:	0 - No
	1 - Yes
Default Codes:	9 - Unknown

Notes:
Derive from the patient DRUG TREATMENT and DRUG DOSAGE AND ADMINISTRATION within the ACUTE MYOCARDIAL INFARCTION CARE SPELL.

Use when a diuretic drug is introduced or used in increased dose.

CCAD item name:
Thiazide diuretic

This data element is also known by these names:

Context	Alias
plural	AMI DRUG TREATMENTS (THIAZIDE DIURETIC)

AMI DRUG TREATMENT (THIENOPYRIDINE PLATELET INHIBITOR)

AMI DRUG TREATMENT (THIENOPYRIDINE PLATELET INHIBITOR)

Format/length:	n1
HES item:
National Codes:	0 - No
	1 - Yes
Default Codes:	9 - Unknown

Notes:
Derive from the patient DRUG TREATMENT and DRUG DOSAGE AND ADMINISTRATION within the ACUTE MYOCARDIAL INFARCTION CARE SPELL.

For example - clopidogrel, ticlopidine.

CCAD item name:
Thienopyridine platelet inhibitor

This data element is also known by these names:

Context	Alias
plural	AMI DRUG TREATMENTS (THIENOPYRIDINE PLATELET INHIBITOR)

AMI DRUG TREATMENT (UNFRACTIONATED HEPARIN)

AMI DRUG TREATMENT (UNFRACTIONATED HEPARIN)

Format/length:	n1
HES item:
National Codes:	0 - No
	1 - Yes
Default Codes:	9 - Unknown

Notes:
Derive from the patient DRUG TREATMENT and DRUG DOSAGE AND ADMINISTRATION within the ACUTE MYOCARDIAL INFARCTION CARE SPELL.

Use of unfractionated heparin as therapy for ACS or STE AMI either alone or in conjunction with other treatment.

CCAD item name:
Unfractionated heparin

This data element is also known by these names:

Context	Alias
plural	AMI DRUG TREATMENTS (UNFRACTIONATED HEPARIN)

AMI DRUG TREATMENT (WARFARIN)

AMI DRUG TREATMENT (WARFARIN)

Format/length:	n1
HES item:
National Codes:	0 - No
	1 - Yes
Default Codes:	9 - Unknown

Notes:
Derive from the patient DRUG TREATMENT and DRUG DOSAGE AND ADMINISTRATION within the ACUTE MYOCARDIAL INFARCTION CARE SPELL.

CCAD item name:
Warfarin

This data element is also known by these names:

Context	Alias
plural	AMI DRUG TREATMENTS (WARFARIN)

AMI HEART RATE

AMI HEART RATE

Format/length:	n3
HES item:
National Codes:
Default Codes:

Notes:
The heart rate recorded from the first ECG after admission to hospital, whilst in a stable cardiac rhythm i.e. sinus rhythm, or chronic AF. In complete heart block record ventricular rate. Where the presenting rhythm is a treatable tachyarrhythmia, the first stable heart rate after treatment should be used.

CCAD item name:
Heart Rate

This data element is also known by these names:

Context	Alias
plural	AMI HEART RATES

ANGIOGRAM DATE

ANGIOGRAM DATE

Format/length:	an10 (ccyy-mm-dd)
HES item:
National Codes:	Press Definition button for the National Codes
Default Codes:

Notes:
The date on which an angiogram is performed with the ACUTE MYOCARDIAL INFARCTION CARE SPELL.

CCAD item name:
Date of angio performed locally

This data element is also known by these names:

Context	Alias
plural	ANGIOGRAM DATES

ASPIRIN THERAPY LOCATION

ASPIRIN THERAPY LOCATION

Format/length:	n1
HES item:
National Codes:	Press Definition button for the National Codes
Default Codes:	9 - Unknown

Notes:

CCAD item name:
Where was Aspirin Given

This data element is also known by these names:

Context	Alias
plural	ASPIRIN THERAPY LOCATIONS

BLEED COMPLICATION

BLEED COMPLICATION

Format/length:	n1
HES item:
National Codes:	Press Definition button for the National Codes
Default Codes:	9 - Unknown

Notes:
Options in order of preference: use highest item that applies.

CCAD item name:
Bleeding complications

This data element is also known by these names:

Context	Alias
plural	BLEED COMPLICATIONS

CARDIAC ARREST FIRST VERIFIED DATE AND TIME

CARDIAC ARREST FIRST VERIFIED DATE AND TIME

Format/length:	an10 (ccyy-mm-dd) an8 (hh:mm:ss)
HES item:
National Codes:
Default Codes:

Notes:
This is the START DATE and START TIME for the first verified CARDIAC ARREST within the ACUTE MYOCARDIAL INFARCTION CARE SPELL.

Date and time of FIRST verified arrest only to be reported. Excludes syncope or profound vagally-mediated bradycardia. Enter date and time of death if resuscitation not attempted.

CCAD item name:
Cardiac arrest date/time - FIRST ARREST ONLY

This data element is also known by these names:

Context	Alias
plural	CARDIAC ARREST FIRST VERIFIED DATES AND TIMES

CARDIAC ARREST LOCATION

CARDIAC ARREST LOCATION

Format/length:	n1
HES item:
National Codes:	Press Definition button for the National Codes
Default Codes:	1 - No arrest

Notes:

CCAD item name:
Cardiac arrest location

This data element is also known by these names:

Context	Alias
plural	CARDIAC ARREST LOCATIONS

CARDIAC ARREST OUTCOME (FIRST)

CARDIAC ARREST OUTCOME (FIRST)

Format/length:	n1
HES item:
National Codes:	Press Definition button for the National Codes
Default Codes:	9 - Unknown

Notes:
CARDIAC ARREST OUTCOME (FIRST) is the same as attribute CARDIAC ARREST OUTCOME.

Applies only to outcome of the first arrest. This should include arrests in which resuscitation was deemed to be inappropriate. Enter the fact that resuscitation was not attempted for whatever reason (such as severe co-morbidity). If further arrests occur, the outcome will be recorded as AMI CAUSE OF DEATH IN HOSPITAL.

CCAD item name:
Outcome Of Arrest

This data element is also known by these names:

Context	Alias
plural	CARDIAC ARREST OUTCOMES (FIRST)

CARDIAC ARREST PRESENTING RHYTHM

CARDIAC ARREST PRESENTING RHYTHM

Format/length:	n1
HES item:
National Codes:	Press Definition button for the National Codes
Default Codes:	9 - Unknown

Notes:

CCAD item name:
Arrest Presenting Rhythm

This data element is also known by these names:

Context	Alias
plural	CARDIAC ARREST PRESENTING RHYTHMS

CARDIAC ENZYMES OR MARKERS RAISED

CARDIAC ENZYMES OR MARKERS RAISED

Format/length:	n1
HES item:
National Codes:	0 - No
	1 - Yes
Default Codes:	9 - Unknown

Notes:
Derive from CLINICAL INVESTIGATION RESULT ITEM/NUMERICAL VALUE.

CCAD item name:
Cardiac Enzymes/Markers Raised

This data element is also known by these names:

Context	Alias
plural	CARDIAC ENZYMES OR MARKERS RAISED

CCAD HOSPITAL IDENTIFIER

CCAD HOSPITAL IDENTIFIER

Format/length:	n3
HES item:
National Codes:
Default Codes:

Notes:
The identifier allocated to the hospital by the Central Cardiac Audit Database (CCAD). A legacy system used by CCAD for identification and analysis of an individual centre data.

The national standard for hospital identification is SITE CODE (OF TREATMENT) and must also be included in the national Data Set.

See www.ccad.org.uk

CCAD item name:
Hospital Identifier

This data element is also known by these names:

Context	Alias
plural	CCAD HOSPITAL IDENTIFIERS

CCAD HOSPITAL IDENTIFIER (REFERRING)

CCAD HOSPITAL IDENTIFIER (REFERRING)

Format/length:	n3
HES item:
National Codes:	See www.ccad.org.uk
Default Codes:

Notes:
CCAD HOSPITAL IDENTIFIER (REFERRING) is the same as attribute CCAD HOSPITAL IDENTIFIER.

CCAD item name:
Referral centre

This data element is also known by these names:

Context	Alias
plural	CCAD HOSPITAL IDENTIFIERS (REFERRING)

CORONARY ANGIOGRAPHY PERFORMED

CORONARY ANGIOGRAPHY PERFORMED

Format/length:	n1
HES item:
National Codes:	Press Definition button for the National Codes
Default Codes:	9 - Unknown

Notes:

CCAD item name:
Coronary Angiography at this Admission

This data element is also known by these names:

Context	Alias
plural	CORONARY ANGIOGRAPHIES PERFORMED

CORONARY INTERVENTION PERFORMED

CORONARY INTERVENTION PERFORMED

Format/length:	n1
HES item:
National Codes:	Press Definition button for the National Codes
Default Codes:	9 - Unknown

Notes:
Procedure for recurrent symptoms or as an elective procedure.

CCAD item name:
Coronary Intervention at this Admission

This data element is also known by these names:

Context	Alias
plural	CORONARY INTERVENTIONS PERFORMED

DISCHARGED ON ANGIOTENSIN INHIBITOR

DISCHARGED ON ANGIOTENSIN INHIBITOR

Format/length:	n1
HES item:
National Codes:	Press Definition button for the National Codes
Default Codes:	9 - Unknown

Notes:
Patient discharged from hospital on angiotensin converting enzyme inhibitor or angiotensin receptor blocker.

CCAD item name:
Angiotensin Inhibitor

This data element is also known by these names:

Context	Alias
plural	DISCHARGED ON ANGIOTENSIN INHIBITORS

DISCHARGED ON ANTI-PLATELET DRUG

DISCHARGED ON ANTI-PLATELET DRUG

Format/length:	n1
HES item:
National Codes:	Press Definition button for the National Codes
Default Codes:	9 - Unknown

Notes:
Patient discharged from hospital taking aspirin or any other anti-platelet agent.

CCAD item name:
Discharged on Aspirin or Other Anti-platelet

This data element is also known by these names:

Context	Alias
plural	DISCHARGED ON ANTI-PLATELET DRUGS

DISCHARGED ON BETA BLOCKER

DISCHARGED ON BETA BLOCKER

Format/length:	n1
HES item:
National Codes:	Press Definition button for the National Codes
Default Codes:	9 - Unknown

Notes:
Patient discharged from hospital on oral beta adrenergic blocker treatment.

CCAD item name:
Discharged On Beta Blocker

This data element is also known by these names:

Context	Alias
plural	DISCHARGED ON BETA BLOCKERS

DISCHARGED ON STATIN

DISCHARGED ON STATIN

Format/length:	n1
HES item:
National Codes:	Press Definition button for the National Codes
Default Codes:	9 - Unknown

Notes:
Patient discharged from hospital on a statin

CCAD item name:
Discharged On Statin

This data element is also known by these names:

Context	Alias
plural	DISCHARGED ON STATIN

ECG DETERMINING TREATMENT

ECG DETERMINING TREATMENT

Format/length:	n1
HES item:
National Codes:	Press Definition button for the National Codes
Default Codes:	9 - Unknown

Notes:
The ECG appearances upon which a decision to offer reperfusion treatment including angioplasty, was based.

CCAD item name:
ECG Determining Treatment

This data element is also known by these names:

Context	Alias
plural	ECG DETERMINING TREATMENTS

ECHOCARDIOGRAPHY PERFORMED

ECHOCARDIOGRAPHY PERFORMED

Format/length:	n1
HES item:
National Codes:
Default Codes:	9 - Unknown

Notes:
Derive from CLINICAL INTERVENTION whether an echocardiography was performed during the HOSPITAL PROVIDER SPELL within the ACUTE MYOCARDIAL INFARCTION CARE SPELL or is planned after admission and recorded as THERAPY AFTER DISCHARGE with THERAPY TYPE 'echocardiology'.

The derived values are:

0	- No
1	- Yes
2	- Planned after admission

CCAD item name:
Echocardiography

This data element is also known by these names:

Context	Alias
plural	ECHOCARDIOGRAPHIES PERFORMED

EMERGENCY SERVICES ARRIVAL DATE AND TIME (AMI)

EMERGENCY SERVICES ARRIVAL DATE AND TIME (AMI)

Format/length:	an10 (ccyy-mm-dd) an8 (hh:mm:ss)
HES item:
National Codes:
Default Codes:

Notes:
This is the START DATE and START TIME from PERSON OBSERVATION for the ACUTE MYOCARDIAL INFARCTION HISTORY ITEM where the AMI HISTORY ITEM TYPE is 'Arrival of Emergency Service'.

Routine ambulance service data.

CCAD item name:
Date/time of symptom onset

This data element is also known by these names:

Context	Alias
plural	EMERGENCY SERVICES ARRIVAL DATES AND TIMES (AMI)

EXERCISE TEST PERFORMED

EXERCISE TEST PERFORMED

Format/length:	n1
HES item:
National Codes:
Default Codes:	9 - Unknown

Notes:
Derive from CLINICAL INTERVENTION whether an exercise test was performed during the HOSPITAL PROVIDER SPELL within the ACUTE MYOCARDIAL INFARCTION CARE SPELL or is planned after admission and recorded as THERAPY AFTER DISCHARGE with THERAPY TYPE 'exercise test'.

The derived values are:

0	- No
1	- Yes
2	- Planned after admission

CCAD item name:
Exercise Test

This data element is also known by these names:

Context	Alias
plural	EXERCISE TESTS PERFORMED

INITIAL CONTACT TYPE

INITIAL CONTACT TYPE

Format/length:	n2
HES item:
National Codes:	Press Definition button for the National Codes
Default Codes:	99 - Unknown

Notes:
In every case the caller refers to the patient or other non-professional in attendance.

CCAD item name:
Method of Admission

This data element is also known by these names:

Context	Alias
plural	INITIAL CONTACT TYPES

INITIAL PATIENT CONTACT DATE AND TIME

INITIAL PATIENT CONTACT DATE AND TIME

Format/length:	an10 (ccyy-mm-dd) an8 (hh:mm:ss)
HES item:
National Codes:
Default Codes:

Notes:
This is the INITIAL PATIENT CONTACT DATE and INITIAL PATIENT CONTACT TIME of a PATIENT INITIATED AMI CARE SPELL.

The time of the initial call by patient, relative or attendant. This may be to a GP, NHS Direct, or the ambulance service.

This time may be available from the ambulance service record as the time of the emergency call, but may only be correct when a 999 call is made to the Ambulance service. Identify to whom the initial call was made. If the call was to a GP (or deputising service), or NHS Direct, establish this time as accurately as possible from the patient. An important time to record wherever possible for standard 6 of the CHD NSF.

CCAD item name:
Date/time of call for help

This data element is also known by these names:

Context	Alias
plural	INITIAL PATIENT CONTACTS DATE AND TIME

INTERVENTION DATE (FIRST IN AMI CARE SPELL)

INTERVENTION DATE (FIRST IN AMI CARE SPELL)

Format/length:	an10 (ccyy-mm-dd) an8 (hh:mm:ss)
HES item:
National Codes:
Default Codes:

Notes:
The CLINICAL INTERVENTION DATE of the first CLINICAL INTERVENTION within the ACUTE MYOCARDIAL INFARCTION CARE SPELL performed within the same hospital.

CCAD item name:
Date of first intervention or surgery performed locally

This data element is also known by these names:

Context	Alias
plural	INTERVENTION DATES (FIRST IN AMI CARE SPELL)

INVESTIGATION TRANSFER DATE

INVESTIGATION TRANSFER DATE

Format/length:	an10 (ccyy-mm-dd)
HES item:
National Codes:
Default Codes:

Notes:
The date on which transfer took place for daycase investigation and/or interventional treatment within an ACUTE MYOCARDIAL INFARCTION CARE SPELL. Arranged daycase transfers are not discharged from hospital.

If a patient is discharged (to another hospital) leave this field blank, and use fields DISCHARGE DATE (HOSPITAL PROVIDER SPELL) and DISCHARGE DESTINATION (HOSPITAL PROVIDER SPELL). This allows recording of interval between referral and procedure. Dates for ANGIOGRAM DATE and INTERVENTION DATE (FIRST IN AMI CARE SPELL) will be the same date where PCI follows angiography at the same procedure, but it is likely that for some time angiography in a DGH to be followed by intervention elsewhere. This option will be covered by either INVESTIGATION TRANSFER DATE, in the case of a day case transfer or by DISCHARGE DATE (HOSPITAL PROVIDER SPELL) & DISCHARGE DESTINATION (HOSPITAL PROVIDER SPELL) for a patient discharged.

CCAD item name:
Transfer date for daycase investigation

This data element is also known by these names:

Context	Alias
plural	INVESTIGATION TRANSFER DATES

PATIENT CLINICAL GROUP

PATIENT CLINICAL GROUP

Format/length:	n2
HES item:
National Codes:	Press Definition button for the National Codes
Default Codes:	09 - Unknown

Notes:
The patient's ethnic group as perceived by the clinician and recorded as part of the AMI Data Set.

CCAD item name:
Patient Ethnic Group

This data element is also known by these names:

Context	Alias
plural	PATIENT CLINICAL GROUPS

PATIENT FAMILY OR SURNAME

PATIENT FAMILY OR SURNAME

Format/length:	an35
HES item:
National Codes:
Default Codes:

This is the PERSON NAME WORD TYPE where b. is the Family or Surname

This data element is also known by these names:

Context	Alias
plural	PATIENT FAMILY OR SURNAMES

PATIENT FORENAME OR PERSONAL NAME

PATIENT FORENAME OR PERSONAL NAME

Format/length:	an35
HES item:
National Codes:
Default Codes:

This is the PERSON NAME WORD TYPE c. Forename.

This data element is also known by these names:

Context	Alias
plural	PATIENT FORENAME OR PERSONAL NAMES

PEAK CREATINE KINASE

PEAK CREATINE KINASE

Format/length:	nn/n
HES item:
National Codes:
Default Codes:

Notes:
Derive from CLINICAL INVESTIGATION RESULT ITEM/NUMERICAL VALUE.

The unit of measure is iu/l (international units per litre).

The biochemical definition of acute infarction and acute coronary syndromes has to take account of proposed changes of biochemical criteria which have not yet gained widespread agreement or acceptance. Entry of the peak value for the two markers allows either or both to be recorded. This allows for the reality that some Trusts are using different cut off points for troponin for the definition of infarction. The rest are likely still to be using creatine kinase (CK).

CCAD item name:
Peak CK

This data element is also known by these names:

Context	Alias
plural	PEAK CREATINE KINASE

PEAK TROPONIN

PEAK TROPONIN

Format/length:	nn/nn
HES item:
National Codes:
Default Codes:

Notes:
Derive from CLINICAL INVESTIGATION RESULT ITEM/NUMERICAL VALUE.

The unit of measure is ng/ml (nanograms per millilitre).

Peak troponin (I or T) during admission

CCAD item name:
Peak Troponin

This data element is also known by these names:

Context	Alias
plural	PEAK TROPONIN

PERSON HISTORY (PREVIOUS CABG)

PERSON HISTORY (PREVIOUS CABG)

Format/length:	n1
HES item:
National Codes:
Default Codes:	9 - Unknown

Notes:
Derive from PATIENT PROCEDURE history.

Indicates whether the patient has had a coronary artery bypass graft at any time prior to this admission.

The derived values are:

0	- No
1	- Yes

CCAD item name:
Previous CABG

This data element is also known by these names:

Context	Alias
plural	PERSON HISTORY (PREVIOUS CABG)

PERSON HISTORY (PREVIOUS PCI)

PERSON HISTORY (PREVIOUS PCI)

Format/length:	n1
HES item:
National Codes:
Default Codes:	9 - Unknown

Notes:
Derive from PATIENT PROCEDURE history.

Indicates if the patient underwent a percutaneous coronary intervention at any time prior to this admission.

The derived values are:

0	- No
1	- Yes

CCAD item name:
Previous PCI

This data element is also known by these names:

Context	Alias
plural	PERSON HISTORY (PREVIOUS PCI)

PERSON OBSERVATION HISTORY (ASTHMA OR COPD)

PERSON OBSERVATION HISTORY (ASTHMA OR COPD)

Format/length:	n1
HES item:
National Codes:
Default Codes:	9 - Unknown

Notes:
Derive from DIAGNOSIS in the CLINICAL CLASSIFICATION FOR PERSON sub type of PERSON OBSERVATION.

Any form of obstructive airways disease.

The derived values are:

0	- No
1	- Yes

CCAD item name:
Asthma or COPD

This data element is also known by these names:

Context	Alias
plural	PERSONS OBSERVATION HISTORY (ASTHMA OR COPD)

PERSON OBSERVATION HISTORY (CEREBROVASCULAR DISEASE)

PERSON OBSERVATION HISTORY (CEREBROVASCULAR DISEASE)

Format/length:	n1
HES item:
National Codes:
Default Codes:	9 - Unknown

Notes:
Derive from DIAGNOSIS in the CLINICAL CLASSIFICATION FOR PERSON sub type of PERSON OBSERVATION.

A history of symptoms of cerebrovascular ischaemia. To include transient cerebral ischaemic episodes and events with deficit lasting >24 hrs.

The derived values are:

0	- No
1	- Yes

CCAD item name:
Cerebrovascular disease

This data element is also known by these names:

Context	Alias
plural	PERSON OBSERVATION HISTORY (CEREBROVASCULAR DISEASE)

PERSON OBSERVATION HISTORY (CHRONIC RENAL FAILURE)

PERSON OBSERVATION HISTORY (CHRONIC RENAL FAILURE)

Format/length:	n1
HES item:
National Codes:
Default Codes:	9 - Unknown

Notes:
Derive from PERSON OBSERVATION. Identify where Creatinine chronically >200 micromol/l.

The derived values are:

0	- No
1	- Yes

CCAD item name:
Chronic renal failure

This data element is also known by these names:

Context	Alias
plural	PERSON OBSERVATION HISTORY (CHRONIC RENAL FAILURE)

PERSON OBSERVATION HISTORY (DIABETES TYPE)

PERSON OBSERVATION HISTORY (DIABETES TYPE)

Format/length:	n1
HES item:
National Codes:
Default Codes:	9 - Unknown

Notes:
Derive from DIAGNOSIS in the CLINICAL CLASSIFICATION FOR PERSON sub type of PERSON OBSERVATION and DRUG TREATMENT history.

Identifies the type of management, if any, for diabetes.

The derived values are:

0	- Not Diabetic
1	- Diabetes (dietary control)
2	- Diabetes (oral medicine)
3	- Diabetes (insulin)
4	- Newly diagnosed diabetes

CCAD item name:
Diabetes

This data element is also known by these names:

Context	Alias
plural	PERSON OBSERVATION HISTORY (DIABETES TYPE)

PERSON OBSERVATION HISTORY (HEART FAILURE)

PERSON OBSERVATION HISTORY (HEART FAILURE)

Format/length:	n1
HES item:
National Codes:
Default Codes:	9 - Unknown

Notes:
Derive from DIAGNOSIS in the CLINICAL CLASSIFICATION FOR PERSON sub type of PERSON OBSERVATION.

A previously validated diagnosis of heart failure on any therapeutic regime.

The derived values ares:

0	- No
1	- Yes

CCAD item name:
Heart failure

This data element is also known by these names:

Context	Alias
plural	PERSON OBSERVATION HISTORY (HEART FAILURE)

PERSON OBSERVATION HISTORY (HYPERCHOLESTEROLAEMIA)

PERSON OBSERVATION HISTORY (HYPERCHOLESTEROLAEMIA)

Format/length:	n1
HES item:
National Codes:
Default Codes:	9 - Unknown

Notes:
Derive from PERSON OBSERVATION and DRUG TREATMENT history.

Identifies if patient has elevation of serum cholesterol requiring dietary or drug treatment.

The derived values ares:

0	- No
1	- Yes

CCAD item name:
Hypercholesterolaemia

This data element is also known by these names:

Context	Alias
plural	PERSON OBSERVATION HISTORY (HYPERCHOLESTEROLAEMIA)

PERSON OBSERVATION HISTORY (HYPERTENSION)

PERSON OBSERVATION HISTORY (HYPERTENSION)

Format/length:	n1
HES item:
National Codes:
Default Codes:	9 - Unknown

Notes:
Derive from PERSON OBSERVATION history.

Identifies if the patient has hypertension.

A patient is defined as having hypertension if they are receiving treatment or dietary advice or if blood pressure has been recorded at greater than 140/90 on at least two occasions prior to admission.

The derived values ares:

0	- No
1	- Yes

CCAD item name:
Hypertension

This data element is also known by these names:

Context	Alias
plural	PERSON OBSERVATION HISTORY (HYPERTENSION)