Rural-Urban Differences in Outcomes of Acute Cardiac Admissions in a Large Health Service.

acute coronary syndrome atrial fibrillation cardiovascular risk factors heart failure rural

Journal

JACC. Advances
ISSN: 2772-963X
Titre abrégé: JACC Adv
Pays: United States
ID NLM: 9918419284106676

Informations de publication

Date de publication:
Nov 2024
Historique:
received: 02 02 2024
revised: 23 08 2024
accepted: 03 09 2024
medline: 29 10 2024
pubmed: 29 10 2024
entrez: 29 10 2024
Statut: epublish

Résumé

Cardiovascular disease (CVD) is a leading cause of morbidity and mortality and residing in a rural and remote region is associated with an increased risk. The impact of rurality on CVD outcomes needs to be fully elucidated. The purpose of this study was to assess the difference in mortality, readmission within 30 days, total readmissions, survival, and total emergency department (ED) presentations following an index CVD admission among patients from rural or remote areas as compared to metropolitan areas. This retrospective observational study included all index hospitalizations with heart failure (HF), atrial fibrillation (AF), or acute coronary syndrome (ACS) within the Hunter New England region of Australia, between January 1, 2008, and December 31, 2021. There were 27,995 ACS admissions, 15,586 HF admissions, and 16,935 AF admissions. Patients from a rural or remote area presenting with CVD presentations had increased 30-day readmission (OR: 1.19; This study highlights the increased incidence of ED presentations and hospital readmissions, for those living in rural Australia, illustrating the disparity in health care provided, and the ongoing need for interventions that address poorer access to specialized health care in the early discharge phase of hospitalization.

Sections du résumé

Background UNASSIGNED
Cardiovascular disease (CVD) is a leading cause of morbidity and mortality and residing in a rural and remote region is associated with an increased risk. The impact of rurality on CVD outcomes needs to be fully elucidated.
Objectives UNASSIGNED
The purpose of this study was to assess the difference in mortality, readmission within 30 days, total readmissions, survival, and total emergency department (ED) presentations following an index CVD admission among patients from rural or remote areas as compared to metropolitan areas.
Methods UNASSIGNED
This retrospective observational study included all index hospitalizations with heart failure (HF), atrial fibrillation (AF), or acute coronary syndrome (ACS) within the Hunter New England region of Australia, between January 1, 2008, and December 31, 2021.
Results UNASSIGNED
There were 27,995 ACS admissions, 15,586 HF admissions, and 16,935 AF admissions. Patients from a rural or remote area presenting with CVD presentations had increased 30-day readmission (OR: 1.19;
Conclusions UNASSIGNED
This study highlights the increased incidence of ED presentations and hospital readmissions, for those living in rural Australia, illustrating the disparity in health care provided, and the ongoing need for interventions that address poorer access to specialized health care in the early discharge phase of hospitalization.

Identifiants

DOI: 10.1016/j.jacadv.2024.101328 PMID: 39469611 PMC: PMC11513678
pubmed: 39469611
doi: 10.1016/j.jacadv.2024.101328
pii: S2772-963X(24)00608-2
pmc: PMC11513678
doi:

Types de publication

Journal Article

Langues

eng

Pagination

101328

Informations de copyright

Crown Copyright © 2024 Published by Elsevier on behalf of the American College of Cardiology Foundation.

Déclaration de conflit d'intérêts

Dr Wilsmore has received speaker fees, grant support, and consultancy fees from Medtronic and Boston Scientific; and speaker fees from Boehringer, Pfizer, and Bayer. Dr Sverdlov is supported by the National Heart Foundation of Australia Future Leader Fellowship (Award ID 106025); has received research grants from AstraZeneca, Novartis, Biotronik, RACE Oncology, Bristol Myers Squibb, Roche Diagnostics, and Vifor; and speaker/consultancy fees from Novartis, Bayer, Bristol Myers Squibb, AstraZeneca, Janssen, and Boehringer Ingelheim. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Auteurs

Shanathan Sritharan (S)

Hunter New England Local Health District, New South Wales, Australia.
Hunter Medical Research Institute, New South Wales, Australia.
School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia.

Bradley Wilsmore (B)

Hunter New England Local Health District, New South Wales, Australia.
Hunter Medical Research Institute, New South Wales, Australia.
School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia.

John Wiggers (J)

Hunter New England Local Health District, New South Wales, Australia.
Hunter Medical Research Institute, New South Wales, Australia.
School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia.

Lloyd Butel-Simoes (L)

Hunter New England Local Health District, New South Wales, Australia.
Hunter Medical Research Institute, New South Wales, Australia.
School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia.

Kristy Fakes (K)

Hunter Medical Research Institute, New South Wales, Australia.
Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia.

Michael McGee (M)

Hunter New England Local Health District, New South Wales, Australia.
Hunter Medical Research Institute, New South Wales, Australia.
School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia.

Rhonda Walker (R)

Hunter New England Local Health District, New South Wales, Australia.
Hunter Medical Research Institute, New South Wales, Australia.

Mikaela White (M)

Hunter New England Local Health District, New South Wales, Australia.

Lucy Leigh (L)

Hunter Medical Research Institute, New South Wales, Australia.

Nicholas Collins (N)

Hunter New England Local Health District, New South Wales, Australia.
Hunter Medical Research Institute, New South Wales, Australia.
School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia.

Andrew Boyle (A)

Hunter New England Local Health District, New South Wales, Australia.
Hunter Medical Research Institute, New South Wales, Australia.
School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia.

Aaron L Sverdlov (AL)

Hunter New England Local Health District, New South Wales, Australia.
Hunter Medical Research Institute, New South Wales, Australia.
School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia.
Newcastle Centre of Excellence in Cardio-Oncology, New South Wales, Australia.

Trent Williams (T)

Hunter New England Local Health District, New South Wales, Australia.
Hunter Medical Research Institute, New South Wales, Australia.
Newcastle Centre of Excellence in Cardio-Oncology, New South Wales, Australia.
School of Nursing and Midwifery, College of Health Medicine and Wellbeing, Faculty of Health and Medicine, University of Newcastle, Callaghan Campus, University Drive Callaghan, New South Wales, Australia.

Classifications MeSH