Abstract:
BACKGROUND:There is strong evidence to suggest that social deprivation is linked to health inequalities. In the UK, concerns have been raised regarding disparities in the outcomes of acute cardiac services within the National Health Service (NHS). This study explored whether differences exist in (a) elective hospital presentation time (b) indicators of severity and disease burden and (c) treatment outcomes (hospital stay and mortality) on the basis of the index of multiple deprivation (IMD) status. DESIGN:This study was a retrospective analysis of data from NHS databases for 13,758 patients that had undergone cardiac revascularisation interventions at the Liverpool Heart and Chest Hospital between April 2007-March 2012. METHODS:The data was analysed by descriptive, univariate and multivariate statistics to explore the association between the IMD quintiles (Q1-Q5) and revascularisation type, elective presentation time, hospital length of stay and mortality. RESULTS AND CONCLUSIONS:Univariate analysis indicated that there were significant differences between patients from the most deprived areas (Q5) compared with patients from the least deprived areas (Q1), these included admission volumes, time before presentation to hospital and proportion of non-elective cases. After risk-adjustments, percutaneous coronary intervention patients from Q5 compared with Q1 had significantly greater length of hospital stay and risk of in-hospital major acute cardiovascular events. After multivariate adjustment for baseline risk factors, patients from Q5 were associated with significantly worse five-year survival as compared with Q1 (hazard ratio (HR) 1.52, 95% confidence interval (CI): 1.36-1.71; p < 0.001). In conclusion, there is evidence to suggest that inequalities in cardiac revascularisation choices and outcomes in the UK may be associated with social deprivation.
journal_name
Eur J Prev Cardioljournal_title
European journal of preventive cardiologyauthors
Matata BM,Shaw M,Grayson AD,McShane J,Lucy J,Fisher M,Jackson Mdoi
10.1177/2047487314567000subject
Has Abstractpub_date
2016-02-01 00:00:00pages
316-27issue
3eissn
2047-4873issn
2047-4881pii
2047487314567000journal_volume
23pub_type
杂志文章abstract:BACKGROUND:Evaluation of health-related quality of life (HRQL) is important in improving the quality of patient care. The aim of this study was to determine the psychometric properties of the HeartQoL in patients with ischemic heart disease (IHD), specifically angina, myocardial infarction (MI), or ischemic heart failu...
journal_title:European journal of preventive cardiology
pub_type: 杂志文章,多中心研究
doi:10.1177/2047487312450545
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journal_title:European journal of preventive cardiology
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journal_title:European journal of preventive cardiology
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journal_title:European journal of preventive cardiology
pub_type: 杂志文章,随机对照试验
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journal_title:European journal of preventive cardiology
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更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Prospective relationships between sedentary behaviour and cardiorespiratory and metabolic markers need to be better delineated in adults with different physical activity levels. We examined the separate and combined relationships of work and leisure time sitting and moderate to vigorous physical activity (MV...
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pub_type: 杂志文章,多中心研究
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更新日期:2019-12-01 00:00:00
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更新日期:2015-06-01 00:00:00
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