我们使用2006年至2016年的数据,在FDASentinel系统的7个集成递送系统中进行了回顾性公共卫生监测。我们通过临床和基于索赔的定义确定了小儿高血压患者,并比较了人口统计学,基线配置文件和随访时间配置文件。在3,757,803名3至17岁的儿科患者中,我们确定了781,722名儿童和551,246名青少年在36个月内进行了至少3次血压测量.其中,70,315名儿童(9%)和47,928名青少年(8.7%)符合高血压的临床定义,22,465名(2.8%)儿童和60,952名(11%)青少年符合高血压的临床定义,非高血压血压。在370万患者中,我们确定了3,246名儿童和7,293名青少年有任何高血压索赔(索赔定义).在符合我们临床定义的人群中,高血压声称的证据很差;2.2%和7.3%的临床高血压儿童和青少年有相应的高血压声称。与临床患者相比,基于索赔的高血压患者的基线资料表明疾病严重程度更高。基于索赔的患者在随访期间显示出较高的全因死亡率。基于索赔的数据源中的小儿高血压未被捕获,但可能作为疾病严重程度更大的标志。在为未来的儿科高血压工作选择现实世界的数据源时,研究人员应该了解编码实践。
We conducted retrospective public health surveillance using data from 2006 to 2016 in seven integrated delivery systems from FDA\'s Sentinel System. We identified pediatric hypertensive patients by clinical and claims-based definitions and compared demographics, baseline profiles and follow-up time profiles. Among 3,757,803 pediatric patients aged 3 to 17 years, we identified 781,722 children and 551,246 teens with at least three blood pressure measures over 36-months. Of these, 70,315 children (9%) and 47,928 teens (8.7%) met the clinical definition for hypertension and 22,465 (2.8%) children and 60,952 (11%) of teens met the clinical definition for elevated, non-hypertensive blood pressure. Of the 3.7M patients, we identified 3,246 children and 7,293 teens with any claim for hypertension (claims definition). Evidence of hypertension claims among those meeting our clinical definition was poor; 2.2% and 7.3% of clinically hypertensive children and teens had corresponding claims for hypertension. Baseline profiles for claims-based hypertensive patients suggest greater severity of disease compared to clinical patients. Claims-based patients showed higher rates of all-cause mortality during follow-up. Pediatric hypertension in claims-based data sources is under-captured but may serve as a marker for greater disease severity. Investigators should understand coding practices when selecting real-world data sources for future pediatric hypertension work.