Paul Wiemers1, Lucy Marney2, Reinhold Muller3, Matthew Brandon2, Praveen Kuchu2, Kasandra Kuhlar2, Chimezie Uchime2, Dong Kang2, Nicole White4, Rachel Greenup5, John F Fraser6, Sumit Yadav2, Robert Tam2. 1. Department of Cardiothoracic Surgery, The Townsville Hospital, Queensland, Australia; University of Queensland School of Medicine, Brisbane, Australia. Electronic address: paul_wiemers@health.qld.gov.au. 2. Department of Cardiothoracic Surgery, The Townsville Hospital, Queensland, Australia. 3. School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Queensland, Australia. 4. Mathematical Sciences School, Queensland University of Technology, Brisbane, Australia. 5. Intensive Care Unit, Princess Alexandra Hospital, Brisbane, Australia. 6. University of Queensland School of Medicine, Brisbane, Australia; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.
Abstract
BACKGROUND: Cardiovascular disease remains the leading cause of mortality in the Indigenous Australian population. Limited research exists in regards to cardiac surgery in the Aboriginal and Torres Strait Islander (ATSI) population. We aimed to investigate risk profiles, surgical pathologies, surgical management and short term outcomes in a contemporary group of patients. METHODS: Variables were assessed for 557 consecutive patients who underwent surgery at our institution between August 2008 and March 2010. RESULTS: 19.2% (107/557) of patients were of Indigenous origin. ATSI patients were significantly younger at time of surgery (mean age 54.1±13.23 vs. 63.1±12.46; p=<0.001) with higher rates of preventable risk factors. Rheumatic heart disease (RHD) was the dominant valvular pathology observed in the Indigenous population. Significantly higher rates of left ventricular impairment and more diffuse coronary artery disease were observed in ATSI patients. A non-significant trend towards higher 30-day mortality was observed in the Indigenous population (5.6% vs. 3.1%; p=0.244). CONCLUSIONS: Cardiac surgery is generally required at a younger age in the Indigenous population with patients often presenting with more advanced disease. Despite often more advanced disease, surgical outcomes do not differ significantly from non-Indigenous patients. Continued focus on preventative strategies for coronary artery disease and RHD in the Indigenous population is required.
BACKGROUND:Cardiovascular disease remains the leading cause of mortality in the Indigenous Australian population. Limited research exists in regards to cardiac surgery in the Aboriginal and Torres Strait Islander (ATSI) population. We aimed to investigate risk profiles, surgical pathologies, surgical management and short term outcomes in a contemporary group of patients. METHODS: Variables were assessed for 557 consecutive patients who underwent surgery at our institution between August 2008 and March 2010. RESULTS: 19.2% (107/557) of patients were of Indigenous origin. ATSI patients were significantly younger at time of surgery (mean age 54.1±13.23 vs. 63.1±12.46; p=<0.001) with higher rates of preventable risk factors. Rheumatic heart disease (RHD) was the dominant valvular pathology observed in the Indigenous population. Significantly higher rates of left ventricular impairment and more diffuse coronary artery disease were observed in ATSI patients. A non-significant trend towards higher 30-day mortality was observed in the Indigenous population (5.6% vs. 3.1%; p=0.244). CONCLUSIONS: Cardiac surgery is generally required at a younger age in the Indigenous population with patients often presenting with more advanced disease. Despite often more advanced disease, surgical outcomes do not differ significantly from non-Indigenous patients. Continued focus on preventative strategies for coronary artery disease and RHD in the Indigenous population is required.
Authors: Elizabeth Anne Russell; Lavinia Tran; Robert A Baker; Jayme S Bennetts; Alex Brown; Christopher Michael Reid; Robert Tam; Warren Frederick Walsh; Graeme Paul Maguire Journal: BMC Cardiovasc Disord Date: 2014-10-02 Impact factor: 2.298