Cardiac surgery in indigenous Australians - How wide is 'The Gap'?

Wiemers, Paul, Marney, Lucy, Muller, Reinhold, Brandon, Matthew, Kuchu, Praveen, Kuhlar, Kasandra, Uchime, Chimezie, Kang, Dong, White, Nicole, Greenup, Rachel, Fraser, John F., Yadav, Sumit and Tam, Robert (2014) Cardiac surgery in indigenous Australians - How wide is 'The Gap'?. Heart Lung and Circulation, 23 3: 265-272. doi:10.1016/j.hlc.2013.09.002


Author Wiemers, Paul
Marney, Lucy
Muller, Reinhold
Brandon, Matthew
Kuchu, Praveen
Kuhlar, Kasandra
Uchime, Chimezie
Kang, Dong
White, Nicole
Greenup, Rachel
Fraser, John F.
Yadav, Sumit
Tam, Robert
Title Cardiac surgery in indigenous Australians - How wide is 'The Gap'?
Journal name Heart Lung and Circulation   Check publisher's open access policy
ISSN 1443-9506
1444-2892
Publication date 2014-01-01
Year available 2013
Sub-type Article (original research)
DOI 10.1016/j.hlc.2013.09.002
Open Access Status Not Open Access
Volume 23
Issue 3
Start page 265
End page 272
Total pages 8
Place of publication Chatswood, NSW, Australia
Publisher Elsevier
Language eng
Formatted 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. 
Keyword Australia
Cardiac surgical procedures
Coronary artery disease
Indigenous population
Outcomes
Rheumatic heart disease
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Medicine Publications
 
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