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). pp. 265-272.

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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.

Item ID: 32966
Item Type: Article (Research - C1)
ISSN: 1444-2892
Keywords: cardiac surgical procedures; Indigenous population; rheumatic heart disease; coronary artery disease; Australia; outcomes
Funders: Office of Health and Medical Research
Date Deposited: 30 Apr 2014 09:42
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111701 Aboriginal and Torres Strait Islander Health @ 100%
SEO Codes: 92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920499 Public Health (excl. Specific Population Health) not elsewhere classified @ 100%
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