Doctors are keen to use heart surgery to ease a chronic problem that is becoming more and more common in hospitals.
The most common problem is that patients with high blood pressure and heart failure can’t get the surgery they need, and patients who can’t afford it have to wait for a more advanced procedure.
But the procedure is often performed at a hospital with a high volume of patients.
The problem is not just limited to heart failure, says Dr Rishi Sharma, a cardiologist at the University of Queensland in Brisbane.
“In a majority of cases, heart surgery can be very expensive, and it’s an expensive procedure,” he says.
Dr Sharma and his colleagues analysed data from the Queensland Heart Surgery Registry (QSHR), a database of cardiac surgeries performed between 2006 and 2015.
The data shows that of more than 1,000 cardiac surgeries done in Queensland between 2006-2015, at least 100 were performed at hospitals with a volume of more the than 100 patients in the QSHR.
Dr Singh says it’s no surprise that hospitals with high volume tend to have a higher number of patients with heart failure.
“The higher the volume of the hospital, the higher the number of cardiac surgery patients,” he explains.
“If there’s more patients, the number will increase.
That’s the general pattern.”
Dr Singh and his team analysed data on more than 10,000 surgeries performed in Queensland hospitals from 2006-15.
It found that the majority of heart surgeries performed at the QSHR were for people with high-risk conditions.
This could include high blood pressures, high cholesterol, high blood sugar, and diabetes.
The average cost of heart surgery in Queensland was $12,000 for those in cardiac surgery and $22,000 per patient for those with a low-risk condition.
But heart failure is the most common heart failure in the Queensland population, accounting for nearly half of all patients admitted to hospitals in the state.
Dr Vijay Singh and Dr Roshan Singh from the University at Albany, New York, wanted to see if it was possible to find a hospital in Queensland with the most heart surgery patients in each year.
So they looked at every cardiac surgery performed in the last two years in Queensland.
They used data from Queensland Heart Foundation, the body that runs the QSMRC, to estimate how many patients in a year there were with heart disease and stroke and heart problems in Queensland, compared to the number in the previous year.
They found that cardiac surgery in the city of Brisbane accounted for roughly 1,800 patients in 2016-17.
This is around three times the number admitted to the QSR in the same year, but it was still only a third of the number who were admitted to hospital.
“This is a big jump,” Dr Singh explains.
The reason, he says, is that heart failure rates have been falling for the past decade.
“We are seeing a very low prevalence of heart failure among older Australians,” he adds.
“People in their 60s and older have been showing lower risk of heart disease.
The other trend is that we’re seeing more patients who have cardiac surgery who are in poor health and in cardiac failure.”
In fact, it’s the elderly who are the biggest risk group for heart failure with a heart failure rate of 10 times higher than the general population.
The team looked at data from QSHRs in other states and territories.
Dr Sivaprakash Shah from the National Heart, Lung and Blood Institute in Melbourne says the Queensland data is promising.
“It’s a very good dataset.
It’s quite representative of Queensland,” he told ABC Radio National.
“They are also quite representative for people who have the most expensive heart surgery.”
“The data shows we are seeing more and longer survival, which is good,” Dr Shah says.
“These results are very encouraging.”
Dr Sharma says the QSSHR data has many important benefits.
It shows that people who can afford to go to hospitals are being admitted.
It gives doctors a sense of how many people are in hospital with heart problems.
And it gives patients a better picture of the patients in their care, and what their needs are.
“All this data has the potential to really help us understand our patients better,” Dr Sharma concludes.
“That’s one of the big benefits.”
Topics: health, medical-research, health-administration, hospital-and-health-services, cardiac, heart-and_blood, qld, australia First posted February 07, 2019 21:40:14 More stories from Queensland