The STOKS acute coronary syndrome registry with online information monitoring: the problem of missing data

Aim. To analyze the frequency of missing data on the time of pain onset, obtained from medical records and patient questionnaires for acute coronary syndrome (ACS), and to evaluate the factors associated with this missing data.

Material and methods. The study was conducted as part of the prospective Stupino Registry of ACS (STOCS), which has included all consecutive patients with ACS or suspected ACS admitted to the regional vascular center since January 10, 2025. Data on the time of angina pain onset were obtained from information in medical records and patient questionnaires.

Results. Data from 261 patients included in the registry for the first 6 months of 2025 were analyzed. Referral diagnoses and diagnoses established upon hospital admission did not comply with current clinical guidelines in almost a third of patients. An analysis of patient records revealed that data on the angina onset was available for only 212 patients and missing for 49 (18,8%). Analysis of questionnaires completed by patients revealed missing information on pain onset in 3,1% of cases. The following factors were associated with missing data in patient records: older age, ST-segment elevation, and prior cerebrovascular accident. Older age and inhospital death were also associated with missing information in patient records.

Conclusion. The study results showed that missing data on the pain onset was present in almost one in five patient records and in only 3% of structured questionnaires completed by patients. The lack of information about the pain onset in medical records and patient questionnaires is not accidental and is associated with a number of factors (advanced age, prior cerebrovascular accident, and inhospital death). Missing data on pain onset can be partially filled in through a structured patient survey, but it is virtually impossible to completely eliminate these omissions.

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