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|Title:||Prevalence and profile of "seasonal frequent flyers" with chronic heart disease: Analysis of 1598 patients and 4588 patient-years follow-up.|
|Authors:||Loader, Jordan;Chan, Yih-Kai;Hawley, John A;Moholdt, Trine;McDonald, Christine F;Jhund, Pardeep;Petrie, Mark C;McMurray, John J;Scuffham, Paul A;Ramchand, Jay;Burrell, Louise M;Stewart, Simon|
|Affiliation:||Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, Australia|
School of Medicine, Menzies Health Institute Queensland, Griffith University, Nathan, Australia
Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
Department of Cardiology, Austin Health, Heidelberg, Victoria, Australia
University of Cape Town, Cape Town, South Africa.
Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
British Heart Foundation Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
|Citation:||International journal of cardiology 2019; 279: 126-132|
|Abstract:||Peaks and troughs in cardiovascular events correlated with seasonal change is well established from an epidemiological perspective but not a clinical one. Retrospective analysis of the recruitment, baseline characteristics and outcomes during minimum 12-month exposure to all four seasons in 1598 disease-management trial patients hospitalised with chronic heart disease. Seasonality was prospectively defined as ≥4 hospitalisations (all-cause) AND >45% of related bed-days occurring in any one season during median 988 (IQR 653, 1394) days follow-up. Patients (39% female) were aged 70 ± 12 years and had a combination of coronary artery disease (58%), heart failure (54%), atrial fibrillation (50%) and multimorbidity. Overall, 29.9% of patients displayed a pattern of seasonality. Independent correlates of seasonality were female gender (adjusted OR 1.27, 95% CI 1.01-1.61; p = 0.042), mild cognitive impairment (adjusted OR 1.51, 95% CI 1.16-1.97; p = 0.002), greater multimorbidity (OR 1.20, 95% CI 1.15-1.26 per Charlson Comorbidity Index Score; p < 0.001), higher systolic (OR 1.01, 95%CI 1.00-1.01 per 1 mmHg; p = 0.002) and lower diastolic (OR 0.99, 95% CI 0.98-1.00 per 1 mmHg; p = 0.002) blood pressure. These patients were more than two-fold more likely to die (adjusted HR 2.16, 95% CI 1.60-2.90; p < 0.001) with the highest and lowest number of deaths occurring during spring (31.7%) and summer (19.9%), respectively. Despite high quality care and regardless of their diagnosis, we identified a significant proportion of "seasonal frequent flyers" with concurrent poor survival in this real-world cohort of patients with chronic heart disease.|
Coronary artery disease
|Appears in Collections:||Journal articles|
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