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International Journal for Equity in Health
Published in: International Journal for Equity in Health 1/2015

Open Access 01-12-2015 | Research

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

Authors: Tiew-Hwa Katherine Teng, Judith M. Katzenellenbogen, Joseph Hung, Matthew Knuiman, Frank M. Sanfilippo, Elizabeth Geelhoed, Dawn Bessarab, Michael Hobbs, Sandra C. Thompson

Published in: International Journal for Equity in Health | Issue 1/2015

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Abstract

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.
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Metadata
Title
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
Authors
Tiew-Hwa Katherine Teng
Judith M. Katzenellenbogen
Joseph Hung
Matthew Knuiman
Frank M. Sanfilippo
Elizabeth Geelhoed
Dawn Bessarab
Michael Hobbs
Sandra C. Thompson
Publication date
01-12-2015
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2015
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-015-0197-4

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