Initial hospitalisation for atrial fibrillation in Aboriginal and non-Aboriginal populations in Western Australia

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Abstract

Objective
The epidemiology of atrial fibrillation (AF) among Aboriginal Australians is poorly described. We compared risk factors, incidence rates and mortality outcomes for first-ever hospitalised AF among Aboriginal and non-Aboriginal Western Australians 20-84 years.

Methods
This retrospective cohort study used whole-of-state person-based linked hospital and deaths data. Incident hospital AF admissions ( previous AF admissionfree for 15 years) were identified and subsequent mortality determined. Disease-specific comorbidity histories were ascertained by 10-year look-back. Agestandardised incidence rates were estimated and the adjusted risk of 30-day and 1-year mortality calculated using regression methods.

Results
Aboriginal patients accounted for 923 (2.5%) of 37 097 incident AF admissions during 2000-2009. Aboriginal patients were younger (mean age 54.8 vs 69.3 years), had lower proportions of primary field AF diagnoses and higher comorbidities than non-Aboriginal patients. The Aboriginal and non-Aboriginal agestandardised incidence rates per 100 000 for men 20-54 years were 197 and 55 (ratio=3.6), for women 20-54 years were 122 and 19 (ratio=6.4), for men 55-84 years were 1151 and 888 (ratio=1.3), and for women 55-84 years were 1050 and 571 (ratio=1.8). While 30-day mortality was similar, crude 1-year mortality risks in Aboriginal and non-Aboriginal patients were 20.6% and 16.3% (adjusted HR=1.24) and 14.4% and 9.9% in 30-day survivors (adjusted HR=1.58).

Conclusions
The incidence (particularly at young ages) and long-term mortality following hospitalised AF is significantly higher in Aboriginal people. Better control of the antecedent risk factors for AF, improved detection and management of AF itself and prevention of its complications are needed.
Original languageEnglish
Pages (from-to)712-719
JournalHeart
Volume101
Issue number9
Early online date19 Feb 2015
DOIs
Publication statusPublished - May 2015

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Western Australia
Atrial Fibrillation
Hospitalization
Population
Mortality
Incidence
Comorbidity
Survivors
Epidemiology
Cohort Studies
Retrospective Studies

Cite this

@article{0e2aebc7c80a4a5eb035718e3c7903c5,
title = "Initial hospitalisation for atrial fibrillation in Aboriginal and non-Aboriginal populations in Western Australia",
abstract = "Objective The epidemiology of atrial fibrillation (AF) among Aboriginal Australians is poorly described. We compared risk factors, incidence rates and mortality outcomes for first-ever hospitalised AF among Aboriginal and non-Aboriginal Western Australians 20-84 years. Methods This retrospective cohort study used whole-of-state person-based linked hospital and deaths data. Incident hospital AF admissions ( previous AF admissionfree for 15 years) were identified and subsequent mortality determined. Disease-specific comorbidity histories were ascertained by 10-year look-back. Agestandardised incidence rates were estimated and the adjusted risk of 30-day and 1-year mortality calculated using regression methods. Results Aboriginal patients accounted for 923 (2.5{\%}) of 37 097 incident AF admissions during 2000-2009. Aboriginal patients were younger (mean age 54.8 vs 69.3 years), had lower proportions of primary field AF diagnoses and higher comorbidities than non-Aboriginal patients. The Aboriginal and non-Aboriginal agestandardised incidence rates per 100 000 for men 20-54 years were 197 and 55 (ratio=3.6), for women 20-54 years were 122 and 19 (ratio=6.4), for men 55-84 years were 1151 and 888 (ratio=1.3), and for women 55-84 years were 1050 and 571 (ratio=1.8). While 30-day mortality was similar, crude 1-year mortality risks in Aboriginal and non-Aboriginal patients were 20.6{\%} and 16.3{\%} (adjusted HR=1.24) and 14.4{\%} and 9.9{\%} in 30-day survivors (adjusted HR=1.58). Conclusions The incidence (particularly at young ages) and long-term mortality following hospitalised AF is significantly higher in Aboriginal people. Better control of the antecedent risk factors for AF, improved detection and management of AF itself and prevention of its complications are needed.",
author = "Judith Katzenellenbogen and Katherine Teng and Derrick Lopez and Joe Hung and Matthew Knuiman and Frank Sanfilippo and Michael Hobbs and Sandra Thompson",
year = "2015",
month = "5",
doi = "10.1136/heartjnl-2014-306678",
language = "English",
volume = "101",
pages = "712--719",
journal = "Heart",
issn = "1355-6037",
publisher = "BMJ Publishing Group",
number = "9",

}

TY - JOUR

T1 - Initial hospitalisation for atrial fibrillation in Aboriginal and non-Aboriginal populations in Western Australia

AU - Katzenellenbogen, Judith

AU - Teng, Katherine

AU - Lopez, Derrick

AU - Hung, Joe

AU - Knuiman, Matthew

AU - Sanfilippo, Frank

AU - Hobbs, Michael

AU - Thompson, Sandra

PY - 2015/5

Y1 - 2015/5

N2 - Objective The epidemiology of atrial fibrillation (AF) among Aboriginal Australians is poorly described. We compared risk factors, incidence rates and mortality outcomes for first-ever hospitalised AF among Aboriginal and non-Aboriginal Western Australians 20-84 years. Methods This retrospective cohort study used whole-of-state person-based linked hospital and deaths data. Incident hospital AF admissions ( previous AF admissionfree for 15 years) were identified and subsequent mortality determined. Disease-specific comorbidity histories were ascertained by 10-year look-back. Agestandardised incidence rates were estimated and the adjusted risk of 30-day and 1-year mortality calculated using regression methods. Results Aboriginal patients accounted for 923 (2.5%) of 37 097 incident AF admissions during 2000-2009. Aboriginal patients were younger (mean age 54.8 vs 69.3 years), had lower proportions of primary field AF diagnoses and higher comorbidities than non-Aboriginal patients. The Aboriginal and non-Aboriginal agestandardised incidence rates per 100 000 for men 20-54 years were 197 and 55 (ratio=3.6), for women 20-54 years were 122 and 19 (ratio=6.4), for men 55-84 years were 1151 and 888 (ratio=1.3), and for women 55-84 years were 1050 and 571 (ratio=1.8). While 30-day mortality was similar, crude 1-year mortality risks in Aboriginal and non-Aboriginal patients were 20.6% and 16.3% (adjusted HR=1.24) and 14.4% and 9.9% in 30-day survivors (adjusted HR=1.58). Conclusions The incidence (particularly at young ages) and long-term mortality following hospitalised AF is significantly higher in Aboriginal people. Better control of the antecedent risk factors for AF, improved detection and management of AF itself and prevention of its complications are needed.

AB - Objective The epidemiology of atrial fibrillation (AF) among Aboriginal Australians is poorly described. We compared risk factors, incidence rates and mortality outcomes for first-ever hospitalised AF among Aboriginal and non-Aboriginal Western Australians 20-84 years. Methods This retrospective cohort study used whole-of-state person-based linked hospital and deaths data. Incident hospital AF admissions ( previous AF admissionfree for 15 years) were identified and subsequent mortality determined. Disease-specific comorbidity histories were ascertained by 10-year look-back. Agestandardised incidence rates were estimated and the adjusted risk of 30-day and 1-year mortality calculated using regression methods. Results Aboriginal patients accounted for 923 (2.5%) of 37 097 incident AF admissions during 2000-2009. Aboriginal patients were younger (mean age 54.8 vs 69.3 years), had lower proportions of primary field AF diagnoses and higher comorbidities than non-Aboriginal patients. The Aboriginal and non-Aboriginal agestandardised incidence rates per 100 000 for men 20-54 years were 197 and 55 (ratio=3.6), for women 20-54 years were 122 and 19 (ratio=6.4), for men 55-84 years were 1151 and 888 (ratio=1.3), and for women 55-84 years were 1050 and 571 (ratio=1.8). While 30-day mortality was similar, crude 1-year mortality risks in Aboriginal and non-Aboriginal patients were 20.6% and 16.3% (adjusted HR=1.24) and 14.4% and 9.9% in 30-day survivors (adjusted HR=1.58). Conclusions The incidence (particularly at young ages) and long-term mortality following hospitalised AF is significantly higher in Aboriginal people. Better control of the antecedent risk factors for AF, improved detection and management of AF itself and prevention of its complications are needed.

U2 - 10.1136/heartjnl-2014-306678

DO - 10.1136/heartjnl-2014-306678

M3 - Article

VL - 101

SP - 712

EP - 719

JO - Heart

JF - Heart

SN - 1355-6037

IS - 9

ER -