Facility disparities in reporting comorbidities to the National Trauma Data Bank.

BACKGROUND: The National Trauma Data Bank (NTDB) includes patient comorbidities. This study evaluates factors of trauma centers associated with higher rates of missing comorbidity data. METHODS: Proportions of missing comorbidity data from facilities in the NTDB from 2011 to 2014 were evaluated for associations with facility characteristics. Proportional impact analysis was performed to identify potential policy targets. RESULTS: Of 919 included facilities, 85% reported comorbidity data in 95% or more cases; only 31.3% were missing no data. Missing rates were significantly different based on most facility categories, but independently associated only with hospital size, region, and trauma center level. Only 15% of centers were responsible for over 80% of cases missing data. CONCLUSIONS: There is significant nonrandom variation in reporting trauma patient comorbidities to the NTDB. Missing data needs to be recognized and considered in studies of trauma comorbidities. Targeted intervention may improve data quality.

Evidence for increased cardiovascular events in the fathers but not mothers of women with polycystic ovary syndrome.

BACKGROUND: Polycystic ovary syndrome (PCOS) is a familial syndrome, associated with multiple cardiovascular disease (CVD) risk factors. Thus, parents of affected women may have a higher prevalence of CVD events than the general population. METHODS: PCOS probands (n = 410) and their participating parents (n = 180 fathers and 211 mothers) were queried for CVD events in themselves and non-participating family members. In order to include the family CVD history of all parents, agreement between the proband and parental reports of CVD events was assessed. Estimated 10-year coronary heart disease (CHD) risk was calculated using the Framingham risk calculator. The National Health and Nutrition Examination Survey (NHANES) 2001-2002 database was used to generate gender, age and body mass index-relevant population parameters of CVD prevalence in the USA population. RESULTS: Ninety-eight percent of the parents' self-reporting of CVD events agreed with the proband's report of parental heart attack history [Kappa = 0.82; 95% CI: (0.69, 0.94)] and 99% with parental stroke history [Kappa = 0.79; 95% CI: (0.62, 0.97)]. Fathers of women with PCOS had a higher prevalence of heart attack and stroke compared with the reference NHANES population (heart attack: 11.1 versus 5.3%, P < 0.0001; stroke: 3.0 versus 1.0%, P = 0.002). Fathers of women with PCOS had an elevated 10-year risk for CHD (11.5 versus 9.9% in NHANES, P = 0.03). No statistically significant increased prevalence of CVD events or 10-year risk was noted in probands or mothers. CONCLUSIONS: Fathers, and not mothers, may be disproportionately burdened with CVD in PCOS families. The strengths of this study include the size of our cohort, the consistent phenotyping and the validation of proband's reporting of parental CVD events.