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.
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 language | English |
|---|---|
| Pages (from-to) | S86 |
| Number of pages | 1 |
| Journal | Heart Lung and Circulation |
| Volume | 26 |
| Issue number | Supplement 2 |
| DOIs | |
| Publication status | Published - 2017 |
| Event | Cardiac 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 2017 → 13 Aug 2017 Conference number: 65 http://www.csanz2017.com/ |