| Mortality, morbidity and evidence-based management amongst patients in regional New Zealand with severe left ventricular systolic dysfunction (1997-2011). Original article. | |
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MedLine Citation:
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PMID: 23425443 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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AIMS: To investigate mortality, quality of life, hospitalisation and evidence-based medical and device management of severe left ventricular (LV) systolic dysfunction in a regional New Zealand setting. METHODS: A retrospective case series was undertaken of 1126 patients with a left ventricular ejection fraction (LVEF) <36% on transthoracic echocardiograms performed between October 1, 1997 and March 31, 2011 in Nelson-Marlborough District Health Board (NMDHB). All-cause mortality and hospitalisation data were analysed for all participants. Substudies were undertaken regarding pharmacotherapy, demographics, implantable cardioverter-defibrillator (ICD) implantation rates and quality of life based on the EQ-5D questionnaire and New York Heart Association (NYHA) class. RESULTS: Five-year cumulative survival was 44.5%. The mean annual medical admission rate was 204/100,000; 54.84% of which were re-admissions in the same year. Prescription rates for angiotensin converting enzyme (ACE) inhibitors/angiotensin-receptor blockers (ARBs), beta-blockers and spironolactone were 68.3%, 74.2% and 24.9% respectively with only 17.6%, 19.0% and 16.4% on maximum recommended doses. ICD devices were inserted in 11.5% of eligible patients. Quality of life was impaired in patients <70 years relative to the age-approximated New Zealand index population. Mean EQ-5D visual analogue score was 72.6±0.032 and self-reported NYHA class 2.09±0.107. CONCLUSION: Patients with severe LV systolic dysfunction in this regional New Zealand community experience similar mortality and first hospitalisation rates to those seen elsewhere in patients with clinical heart failure, but a greater number of re-admissions. Medical and device therapy utilisation was sub-optimal and quality of life impaired, together supporting the need for a dedicated heart failure service. |
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Authors:
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Brian T Grainger; Steve White; Sarah Lake; Andrew Hamer; Nick Fisher; Tammy Pegg |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2013-2-21 |
Journal Detail:
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Title: Internal medicine journal Volume: - ISSN: 1445-5994 ISO Abbreviation: Intern Med J Publication Date: 2013 Feb |
Date Detail:
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Created Date: 2013-2-21 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101092952 Medline TA: Intern Med J Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2013 The Authors. Internal Medicine Journal © 2013 Royal Australasian College of Physicians. |
Affiliation:
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Nelson Marlborough District Health Board, Private Bag 18, Tipahi St, Nelson, 7010, New Zealand. |
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