Indigenous Australians have a greater prevalence of heart, stroke, and vascular disease, are younger at death, with higher hospitalisation and more aeromedical retrievals from remote regions

Summary: Background: We aimed to determine whether heart, stroke, and vascular disease (HSVD) prevalence and emergency primary evacuation (EPE), hospitalisation, and mortality differ by patient characteristics. Methods: An Australian-wide incidence population based study, with prospective data coll...

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Autores principales:	Fergus W Gardiner, PhD.Med, Kristopher Rallah-Baker, B.Med, Angela Dos Santos, MB.BS, Pritish Sharma, MBA, Leonid Churilov, PhD, Geoffrey A Donnan, PhD, Stephen M. Davis, PhD, Frank Quinlan, MSc, Paul Worley, PhD. Med Ed
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/9121ce5788834fefa173ee1b0e06b366
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spelling	oai:doaj.org-article:9121ce5788834fefa173ee1b0e06b3662021-11-04T04:38:34ZIndigenous Australians have a greater prevalence of heart, stroke, and vascular disease, are younger at death, with higher hospitalisation and more aeromedical retrievals from remote regions2589-537010.1016/j.eclinm.2021.101181https://doaj.org/article/9121ce5788834fefa173ee1b0e06b3662021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2589537021004612https://doaj.org/toc/2589-5370Summary: Background: We aimed to determine whether heart, stroke, and vascular disease (HSVD) prevalence and emergency primary evacuation (EPE), hospitalisation, and mortality differ by patient characteristics. Methods: An Australian-wide incidence population based study, with prospective data collected form the 1 July 2019 to the 30 October 2020. Findings: Indigenous Australians reported significantly higher prevalence of HSVD at 229.0 per-1000 as compared to 152.0 per-1000 non-Indigenous Australians: risk ratio 1.5 (95% CI 1.2-1.8). 583 remote patients received an EPE for HSVD, consisting of 388 (66.6%; 95% CI: 62.6-70.4) males and 195 (33.0%; 95% CI: 29.6-37.4) females. There were 289 (49.6%; 95% CI 45.4- 53.7) patients who identified as Indigenous, and 294 (50.4%; 95% CI 46.3- 54.6) as non-Indigenous. The mean Indigenous age during EPE was 48.0 (95% CI 45.9-50.1) years old, significantly lower than the non-Indigenous mean age of 55.6 (95% CI 53.8-57.4). Indigenous patients hospitalised for HSVD were younger, the majority younger than 65 years (n=21175; 73.7% 95% CI 73.2-74.2) as compared to non-Indigenous patients (n= 357654; 33.1% 95% CI 33.0-33.15). When adjusted for HSVD prevalence, remote Indigenous patients had a higher hospitalisation rate as compared to non-remote Indigenous patients (rate ratio: 1.6; 95% CI 1.3-2.0) and remote non-Indigenous patients (rate ratio: 1.2; 95% CI 1.0-1.5). More Indigenous patients died of HSVD before the age of 65 years (n=1875; 56.5% 95% CI 54.8-58.2) as compared to non-Indigenous patients (n= 16161; 10.6% 95% CI 10.45-10.8). Interpretation: Indigenous Australians have a higher prevalence, and younger age during EPE, and hospitalisation for HSVD than non-Indigenous Australians. Funding: This is a self/internally-funded study, with the lead organisation being the Royal Flying Doctor Service (RFDS) of Australia. For the duration of the study period, the RFDS provided in-kind support including one full-time equivalent (FTE) and resources (office space, computer, research software, and office equipment). There was no external funding source that had a role in study design or data analysis or interpretation.Fergus W Gardiner, PhD.MedKristopher Rallah-Baker, B.MedAngela Dos Santos, MB.BSPritish Sharma, MBALeonid Churilov, PhDGeoffrey A Donnan, PhDStephen M. Davis, PhDFrank Quinlan, MScPaul Worley, PhD. Med EdElsevierarticleMedicine (General)R5-920ENEClinicalMedicine, Vol 42, Iss , Pp 101181- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine (General) R5-920
spellingShingle	Medicine (General) R5-920 Fergus W Gardiner, PhD.Med Kristopher Rallah-Baker, B.Med Angela Dos Santos, MB.BS Pritish Sharma, MBA Leonid Churilov, PhD Geoffrey A Donnan, PhD Stephen M. Davis, PhD Frank Quinlan, MSc Paul Worley, PhD. Med Ed Indigenous Australians have a greater prevalence of heart, stroke, and vascular disease, are younger at death, with higher hospitalisation and more aeromedical retrievals from remote regions
description	Summary: Background: We aimed to determine whether heart, stroke, and vascular disease (HSVD) prevalence and emergency primary evacuation (EPE), hospitalisation, and mortality differ by patient characteristics. Methods: An Australian-wide incidence population based study, with prospective data collected form the 1 July 2019 to the 30 October 2020. Findings: Indigenous Australians reported significantly higher prevalence of HSVD at 229.0 per-1000 as compared to 152.0 per-1000 non-Indigenous Australians: risk ratio 1.5 (95% CI 1.2-1.8). 583 remote patients received an EPE for HSVD, consisting of 388 (66.6%; 95% CI: 62.6-70.4) males and 195 (33.0%; 95% CI: 29.6-37.4) females. There were 289 (49.6%; 95% CI 45.4- 53.7) patients who identified as Indigenous, and 294 (50.4%; 95% CI 46.3- 54.6) as non-Indigenous. The mean Indigenous age during EPE was 48.0 (95% CI 45.9-50.1) years old, significantly lower than the non-Indigenous mean age of 55.6 (95% CI 53.8-57.4). Indigenous patients hospitalised for HSVD were younger, the majority younger than 65 years (n=21175; 73.7% 95% CI 73.2-74.2) as compared to non-Indigenous patients (n= 357654; 33.1% 95% CI 33.0-33.15). When adjusted for HSVD prevalence, remote Indigenous patients had a higher hospitalisation rate as compared to non-remote Indigenous patients (rate ratio: 1.6; 95% CI 1.3-2.0) and remote non-Indigenous patients (rate ratio: 1.2; 95% CI 1.0-1.5). More Indigenous patients died of HSVD before the age of 65 years (n=1875; 56.5% 95% CI 54.8-58.2) as compared to non-Indigenous patients (n= 16161; 10.6% 95% CI 10.45-10.8). Interpretation: Indigenous Australians have a higher prevalence, and younger age during EPE, and hospitalisation for HSVD than non-Indigenous Australians. Funding: This is a self/internally-funded study, with the lead organisation being the Royal Flying Doctor Service (RFDS) of Australia. For the duration of the study period, the RFDS provided in-kind support including one full-time equivalent (FTE) and resources (office space, computer, research software, and office equipment). There was no external funding source that had a role in study design or data analysis or interpretation.
format	article
author	Fergus W Gardiner, PhD.Med Kristopher Rallah-Baker, B.Med Angela Dos Santos, MB.BS Pritish Sharma, MBA Leonid Churilov, PhD Geoffrey A Donnan, PhD Stephen M. Davis, PhD Frank Quinlan, MSc Paul Worley, PhD. Med Ed
author_facet	Fergus W Gardiner, PhD.Med Kristopher Rallah-Baker, B.Med Angela Dos Santos, MB.BS Pritish Sharma, MBA Leonid Churilov, PhD Geoffrey A Donnan, PhD Stephen M. Davis, PhD Frank Quinlan, MSc Paul Worley, PhD. Med Ed
author_sort	Fergus W Gardiner, PhD.Med
title	Indigenous Australians have a greater prevalence of heart, stroke, and vascular disease, are younger at death, with higher hospitalisation and more aeromedical retrievals from remote regions
title_short	Indigenous Australians have a greater prevalence of heart, stroke, and vascular disease, are younger at death, with higher hospitalisation and more aeromedical retrievals from remote regions
title_full	Indigenous Australians have a greater prevalence of heart, stroke, and vascular disease, are younger at death, with higher hospitalisation and more aeromedical retrievals from remote regions
title_fullStr	Indigenous Australians have a greater prevalence of heart, stroke, and vascular disease, are younger at death, with higher hospitalisation and more aeromedical retrievals from remote regions
title_full_unstemmed	Indigenous Australians have a greater prevalence of heart, stroke, and vascular disease, are younger at death, with higher hospitalisation and more aeromedical retrievals from remote regions
title_sort	indigenous australians have a greater prevalence of heart, stroke, and vascular disease, are younger at death, with higher hospitalisation and more aeromedical retrievals from remote regions
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/9121ce5788834fefa173ee1b0e06b366
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Indigenous Australians have a greater prevalence of heart, stroke, and vascular disease, are younger at death, with higher hospitalisation and more aeromedical retrievals from remote regions

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