Evidence map›Paper›PMID 36963786›Full record

ArticleBMJ global health2023

Surgery for rheumatic heart disease in the Northern Territory, Australia, 1997-2016: what have we gained?

James Doran, David Canty, Karen Dempsey, Alan Cass, Nadarajah Kangaharan, Bo Remenyi, Georgie Brunsdon, Malcolm McDonald, Clare Heal, Zhiqiang Wang and 21 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ global health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
3.8field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 13 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
  4. Article
  5. Article
  6. Review
  7. The aetiology and incidence of infective endocarditis in people living with rheumatic heart disease in tropical Australia.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2023
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

31 authors at 11 institutions in 2 countries.

James DoranMenzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia james.doran@menzies.edu.au.ORCID 0000-0003-3495-2002
David CantyDepartment of Surgery, University of Melbourne, Parkville, Victoria, Australia.
Karen DempseyMenzies School of Health Research, Royal Darwin Hospital Campus, Rocklands Drive Casuarina, Northern Territory, Australia.
Alan CassMenzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia.
Nadarajah KangaharanCardiology, Royal Darwin Hospital, Casuarina, Darwin, Australia.
Bo RemenyiMenzies School of Health Research, Royal Darwin Hospital Campus, Rocklands Drive Casuarina, Northern Territory, Australia.
Georgie BrunsdonCardiology, Royal Darwin Hospital, Casuarina, Darwin, Australia.
Malcolm McDonaldSchool of Medicine, James Cook University, Cairns, Queensland, Australia.
Clare HealSchool of Medicine and Dentistry, James Cook University, Mackay, Queensland, Australia.
Zhiqiang WangMenzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia.
Colin RoyseDepartment of Surgery, University of Melbourne, Parkville, Victoria, Australia.
Alistair RoyseDepartment of Surgery, University of Melbourne, Parkville, Victoria, Australia.
Jacqueline MeinSchool of Medicine, James Cook University, Cairns, Queensland, Australia.
Nigel GrayMedical Education, NTGPE, Casuarina, Northern Territory, Australia.
Jayme BennettsDepartment of Cardiothoracic Surgery, Adelaide SA, Adelaide, South Australia, Australia.
Robert A BakerDepartment of Cardiothoracic Surgery, Adelaide SA, Adelaide, South Australia, Australia.
Maida StewartMenzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia.
Steven SutcliffeDepartment of Cardiology, Cairns Hospital, Cairns, Queensland, Australia.
Benjamin ReevesDepartment of Paediatrics, Cairns Hospital, Cairns, Queensland, Australia.
Upasna DoranDepartment of Paediatrics, Cairns Hospital, Cairns, Queensland, Australia.
Patricia RankineMedical Education, Northern Territory General Practice Education, Darwin, Northern Territory, Australia.
Richard FejoMedical Education, Northern Territory General Practice Education, Darwin, Northern Territory, Australia.
Elisabeth HeenanMedical Education, Northern Territory General Practice Education, Darwin, Northern Territory, Australia.
Ripudaman JalotaSchool of Medicine, James Cook University, Cairns, Queensland, Australia.
Marcus IltonCardiology, Royal Darwin Hospital, Tiwi, Northern Territory, Australia.
Ross Roberts-ThomsonCardiology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Jason KingAboriginal Community Controlled Health Organisation, Gurriny Yealamucka Health Service Aboriginal Corporation, Yarrabah, Queensland, Australia.
Rosemary WyberThe George Institute for Global Health, Newtown, New South Wales, Australia.ORCID 0000-0003-3904-9269
Jonathan DoranDepartment of Anaesthesia, University Hospital Galway, Galway, Ireland.
Andrew WebsterAboriginal Community Controlled Health Organisation, Danila Dilba Health Service, Darwin, Northern Territory, Australia.
Joshua HansonThe Kirby Institute, Kensington, New South Wales, Australia.
Cairns Hospital · AUThe University of Melbourne · AUCharles Darwin University · AUFlinders University · AUJames Cook University · AUMenzies School of Health Research · AURoyal Adelaide Hospital · AURoyal Darwin Hospital · AUThe Kids Research Institute Australia · AUUniversity Hospital Galway · IEGovernment of the Northern Territory · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBetween 1964 and 1996, the 10-year survival of patients having valve replacement surgery for rheumatic heart disease (RHD) in the Northern Territory, Australia, was 68%. As medical care has evolved since then, this study aimed to determine whether there has been a corresponding improvement in survival.

methodsA retrospective study of Aboriginal patients with RHD in the Northern Territory, Australia, having their first valve surgery between 1997 and 2016. Survival was examined using Kaplan-Meier and Cox regression analysis.

findingsThe cohort included 281 adults and 61 children. The median (IQR) age at first surgery was 31 (18-42) years; 173/342 (51%) had a valve replacement, 113/342 (33%) had a valve repair and 56/342 (16%) had a commissurotomy. There were 93/342 (27%) deaths during a median (IQR) follow-up of 8 (4-12) years. The overall 10-year survival was 70% (95% CI: 64% to 76%). It was 62% (95% CI: 53% to 70%) in those having valve replacement. There were 204/281 (73%) adults with at least 1 preoperative comorbidity. Preoperative comorbidity was associated with earlier death, the risk of death increasing with each comorbidity (HR: 1.3 (95% CI: 1.2 to 1.5), p<0.001). Preoperative chronic kidney disease (HR 6.5 (95% CI: 3.0 to 14.0) p≤0.001)), coronary artery disease (HR 3.3 (95% CI: 1.3 to 8.4) p=0.012) and pulmonary artery systolic pressure>50 mm Hg before surgery (HR 1.9 (95% CI: 1.2 to 3.1) p=0.007) were independently associated with death.

interpretationSurvival after valve replacement for RHD in this region of Australia has not improved. Although the patients were young, many had multiple comorbidities, which influenced long-term outcomes. The increasing prevalence of complex comorbidity in the region is a barrier to achieving optimal health outcomes.

Indexed as

Rheumatic Heart DiseaseAdultAge FactorsChildComorbidityHumansNorthern TerritoryRetrospective StudiesChild healthPublic HealthThoracic surgeryTreatment

Identifiers

PMID36963786
PMCPMC10040039
OpenAlexW4360843917

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.