Long-term trends in inpatient hospital admission rates for unspecified chest pain in Western Australia, 1998-2013

Research output: Contribution to journalAbstract/Meeting Abstract

Abstract

Background: National unlinked data has shown a significant
increase in unspecified chest pain (CP) hospitalisations.
This may reflect awareness campaigns and changes to ED
assessment guidelines including use of troponin. Yet this
patient population is poorly characterised and outcomes
unclear. We investigated long-term trends in unspecified CP
hospitalisation rates and outcomes in WA from 1998-2013.

Methods: Linked hospitalisation/mortality data were used
to identify all inpatient admissions for unspecified CP (ICD-9
786.5, ICD-10 R07.1-R07.4) inWA in 35-94 year-olds, accounting
for transfers. Age-standardised rates were calculated by
the direct method, and age-adjusted trends estimated from
Poisson regression. Risk of inpatient readmission (unspecified
CP and CHD), and all-cause mortality, in index cases at
30-days and 1-year were estimated from Kaplan Meier analyses.

Results: There were a total of 125,855 hospitalisations for
unspecified CP in WA from 1998-2013 (50% males, mean
age 59years, median length of stay 2 days). From 1998-2013,
age-standardised rates doubled, from 472 to 965/100,000 in
men, and 456 to 969/100,000 inwomen(age-adjusted increase
5%/year men, 6%/year women). The unadjusted risk of an
unspecified CP readmission was 3.4% at 30-days and 7.6% at
1-year; risk of readmission for CHD within 1-year was 6.5%;
all-cause mortality following unspecified CP hospitalisation
was 1% at 30-days and 3.5% at 1-year.

Conclusion: Admissions to hospital for unspecifiedCPrepresent
an increasing health burden, likely to increase with an
ageing population, and are not without major adverse consequences
at 1-year. Further analysis is required to understand
the magnitude and factors driving these trends.
Original languageEnglish
Pages (from-to)S86
Number of pages1
JournalHeart Lung and Circulation
Volume26
Issue numberSupplement 2
DOIs
Publication statusPublished - 2017
EventCardiac Society of Australia and New Zealand Annual Scientific Meeting and the International Society for Heart Research Australasian Section Annual Scientific Meeting - Perth Convention and Exhibition Centre, Perth, Australia
Duration: 10 Aug 201713 Aug 2017
Conference number: 65
http://www.csanz2017.com/

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Western Australia
Chest Pain
Inpatients
Hospitalization
Mortality
Troponin
Kaplan-Meier Estimate
International Classification of Diseases
Population
Length of Stay
Guidelines
Health

Cite this

@article{3a6ef6425fc740adb7709ab77b4b56e2,
title = "Long-term trends in inpatient hospital admission rates for unspecified chest pain in Western Australia, 1998-2013",
abstract = "Background: National unlinked data has shown a significantincrease in unspecified chest pain (CP) hospitalisations.This may reflect awareness campaigns and changes to EDassessment guidelines including use of troponin. Yet thispatient population is poorly characterised and outcomesunclear. We investigated long-term trends in unspecified CPhospitalisation rates and outcomes in WA from 1998-2013.Methods: Linked hospitalisation/mortality data were usedto identify all inpatient admissions for unspecified CP (ICD-9786.5, ICD-10 R07.1-R07.4) inWA in 35-94 year-olds, accountingfor transfers. Age-standardised rates were calculated bythe direct method, and age-adjusted trends estimated fromPoisson regression. Risk of inpatient readmission (unspecifiedCP and CHD), and all-cause mortality, in index cases at30-days and 1-year were estimated from Kaplan Meier analyses.Results: There were a total of 125,855 hospitalisations forunspecified CP in WA from 1998-2013 (50{\%} males, meanage 59years, median length of stay 2 days). From 1998-2013,age-standardised rates doubled, from 472 to 965/100,000 inmen, and 456 to 969/100,000 inwomen(age-adjusted increase5{\%}/year men, 6{\%}/year women). The unadjusted risk of anunspecified CP readmission was 3.4{\%} at 30-days and 7.6{\%} at1-year; risk of readmission for CHD within 1-year was 6.5{\%};all-cause mortality following unspecified CP hospitalisationwas 1{\%} at 30-days and 3.5{\%} at 1-year.Conclusion: Admissions to hospital for unspecifiedCPrepresentan increasing health burden, likely to increase with anageing population, and are not without major adverse consequencesat 1-year. Further analysis is required to understandthe magnitude and factors driving these trends.",
author = "Jessica Matthews and Francesco Sanfilippo and Derrick Lopez and Matthew Knuiman and Michael Hobbs and Joseph Hung and Sushma Mathur and John Beilby and Tom Briffa and Lee Nedkoff",
year = "2017",
doi = "10.1016/j.hlc.2017.06.098",
language = "English",
volume = "26",
pages = "S86",
journal = "Heart, Lung & Circulation",
issn = "1444-2892",
publisher = "Academic Press",
number = "Supplement 2",

}

TY - JOUR

T1 - Long-term trends in inpatient hospital admission rates for unspecified chest pain in Western Australia, 1998-2013

AU - Matthews, Jessica

AU - Sanfilippo, Francesco

AU - Lopez, Derrick

AU - Knuiman, Matthew

AU - Hobbs, Michael

AU - Hung, Joseph

AU - Mathur, Sushma

AU - Beilby, John

AU - Briffa, Tom

AU - Nedkoff, Lee

PY - 2017

Y1 - 2017

N2 - Background: National unlinked data has shown a significantincrease in unspecified chest pain (CP) hospitalisations.This may reflect awareness campaigns and changes to EDassessment guidelines including use of troponin. Yet thispatient population is poorly characterised and outcomesunclear. We investigated long-term trends in unspecified CPhospitalisation rates and outcomes in WA from 1998-2013.Methods: Linked hospitalisation/mortality data were usedto identify all inpatient admissions for unspecified CP (ICD-9786.5, ICD-10 R07.1-R07.4) inWA in 35-94 year-olds, accountingfor transfers. Age-standardised rates were calculated bythe direct method, and age-adjusted trends estimated fromPoisson regression. Risk of inpatient readmission (unspecifiedCP and CHD), and all-cause mortality, in index cases at30-days and 1-year were estimated from Kaplan Meier analyses.Results: There were a total of 125,855 hospitalisations forunspecified CP in WA from 1998-2013 (50% males, meanage 59years, median length of stay 2 days). From 1998-2013,age-standardised rates doubled, from 472 to 965/100,000 inmen, and 456 to 969/100,000 inwomen(age-adjusted increase5%/year men, 6%/year women). The unadjusted risk of anunspecified CP readmission was 3.4% at 30-days and 7.6% at1-year; risk of readmission for CHD within 1-year was 6.5%;all-cause mortality following unspecified CP hospitalisationwas 1% at 30-days and 3.5% at 1-year.Conclusion: Admissions to hospital for unspecifiedCPrepresentan increasing health burden, likely to increase with anageing population, and are not without major adverse consequencesat 1-year. Further analysis is required to understandthe magnitude and factors driving these trends.

AB - Background: National unlinked data has shown a significantincrease in unspecified chest pain (CP) hospitalisations.This may reflect awareness campaigns and changes to EDassessment guidelines including use of troponin. Yet thispatient population is poorly characterised and outcomesunclear. We investigated long-term trends in unspecified CPhospitalisation rates and outcomes in WA from 1998-2013.Methods: Linked hospitalisation/mortality data were usedto identify all inpatient admissions for unspecified CP (ICD-9786.5, ICD-10 R07.1-R07.4) inWA in 35-94 year-olds, accountingfor transfers. Age-standardised rates were calculated bythe direct method, and age-adjusted trends estimated fromPoisson regression. Risk of inpatient readmission (unspecifiedCP and CHD), and all-cause mortality, in index cases at30-days and 1-year were estimated from Kaplan Meier analyses.Results: There were a total of 125,855 hospitalisations forunspecified CP in WA from 1998-2013 (50% males, meanage 59years, median length of stay 2 days). From 1998-2013,age-standardised rates doubled, from 472 to 965/100,000 inmen, and 456 to 969/100,000 inwomen(age-adjusted increase5%/year men, 6%/year women). The unadjusted risk of anunspecified CP readmission was 3.4% at 30-days and 7.6% at1-year; risk of readmission for CHD within 1-year was 6.5%;all-cause mortality following unspecified CP hospitalisationwas 1% at 30-days and 3.5% at 1-year.Conclusion: Admissions to hospital for unspecifiedCPrepresentan increasing health burden, likely to increase with anageing population, and are not without major adverse consequencesat 1-year. Further analysis is required to understandthe magnitude and factors driving these trends.

UR - http://www.heartlungcirc.org/article/S1443-9506(17)30637-6/fulltext

U2 - 10.1016/j.hlc.2017.06.098

DO - 10.1016/j.hlc.2017.06.098

M3 - Abstract/Meeting Abstract

VL - 26

SP - S86

JO - Heart, Lung & Circulation

JF - Heart, Lung & Circulation

SN - 1444-2892

IS - Supplement 2

ER -