Prevalence and profile of "seasonal frequent flyers" with chronic heart disease: Analysis of 1598 patients and 4588 patient-years follow-up
Journal article
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. and Stewart, Simon. (2019). Prevalence and profile of "seasonal frequent flyers" with chronic heart disease: Analysis of 1598 patients and 4588 patient-years follow-up. International Journal of Cardiology. 279, pp. 126 - 132. https://doi.org/10.1016/j.ijcard.2018.12.060
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. and Stewart, Simon |
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Abstract | Background Peaks and troughs in cardiovascular events correlated with seasonal change is well established from an epidemiological perspective but not a clinical one. Methods 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. Results 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. Conclusions 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. |
Keywords | cardiovascular seasonality; cardiovascular disease; heart failure; atrial fibrillation; coronary artery disease |
Year | 2019 |
Journal | International Journal of Cardiology |
Journal citation | 279, pp. 126 - 132 |
Publisher | Elsevier Ireland Ltd. |
ISSN | 0167-5273 |
Digital Object Identifier (DOI) | https://doi.org/10.1016/j.ijcard.2018.12.060 |
Scopus EID | 2-s2.0-85059610204 |
Open access | Published as green open access |
Page range | 126 - 132 |
Research Group | Mary MacKillop Institute for Health Research |
Author's accepted manuscript | License File Access Level Open |
Publisher's version | License All rights reserved File Access Level Controlled |
Place of publication | Ireland |
https://acuresearchbank.acu.edu.au/item/88z09/prevalence-and-profile-of-seasonal-frequent-flyers-with-chronic-heart-disease-analysis-of-1598-patients-and-4588-patient-years-follow-up
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AM_Loader_2019_Prevalence_and_profile_of_seasonal_frequent.pdf | |
License: CC BY-NC-ND 4.0 | |
File access level: Open |
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