A cohort study: temporal trends in prevalence of antecedents, comorbidities and mortality in Aboriginal and non-Aboriginal Australians with first heart failure hospitalization, 2000–2009

International Journal for Equity in Health

Sandra C. Thompson⁴  Michael Hobbs¹  Dawn Bessarab³  Elizabeth Geelhoed¹  Frank M. Sanfilippo¹  Matthew Knuiman¹  Joseph Hung²  Judith M. Katzenellenbogen⁴  Tiew-Hwa Katherine Teng⁴ 

[1] School of Population Health, UWA, Perth, Australia;School of Medicine & Pharmacology, Sir Charles Gairdner Hospital Unit, UWA, Perth, Australia;Centre for Aboriginal Medical and Dental Health, UWA, Perth, Australia;Western Australian Centre for Rural Health, University of Western Australia (UWA), Perth, Australia

关键词: Aboriginal;    Indigenous;    Mortality;    Risk factors;    Heart failure;   

Others  :  1222798
DOI  :  10.1186/s12939-015-0197-4

 received in 2014-11-17, accepted in 2015-07-29,  发布年份 2015

【 摘 要 】

Background/objectives

Little is known about trends in risk factors and mortality for Aboriginal Australians with heart failure (HF). This population-based study evaluated trends in prevalence of risk factors, 30-day and 1-year all-cause mortality following first HF hospitalization among Aboriginal and non-Aboriginal Western Australians in the decade 2000–2009.

Methods

Linked-health data were used to identify patients (20–84 years), with a first-ever HF hospitalization. Trends in demographics, comorbidities, interventions and risk factors were evaluated. Logistic and Cox regression models were fitted to test and compare trends over time in 30-day and 1-year mortality.

Results

Of 17,379 HF patients, 1,013 (5.8 %) were Aboriginal. Compared with 2000–2002, the prevalence (as history) of myocardial infarction and hypertension increased more markedly in 2006–2009 in Aboriginal (versus non-Aboriginal) patients, while diabetes and chronic kidney disease remained disproportionately higher in Aboriginal patients. Risk factor trends, including the Charlson comorbidity index, increased over time in younger Aboriginal patients. Risk-adjusted 30-day mortality did not change over the decade in either group. Risk-adjusted 1-year mortality (in 30-day survivors) was non-significantly higher in Aboriginal patients in 2006–2008 compared with 2000–2002 (hazard ratio (HR) 1.44; 95 % CI 0.85-2.41; p-trend = 0.47) whereas it decreased in non-Aboriginal patients (HR 0.87; 95 % CI 0.78-0.97; p-trend = 0.01).

Conclusions

Between 2000 and 2009, the prevalence of HF antecedents increased and remained disproportionately higher in Aboriginal (versus non-Aboriginal) HF patients. Risk-adjusted 1-year mortality did not improve in Aboriginal patients over the period in contrast with non-Aboriginal patients. These findings highlight the need for better prevention and post-HF care in Aboriginal Australians.

【 授权许可】

   
2015 Teng et al.

【 图 表 】

Fig. 1.

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