scholarly journals Epidemiology of cardiovascular death in kidney failure: an Australian and New Zealand cohort study using data linkage

Nephrology ◽  
2022 ◽  
Author(s):  
Victor Khou ◽  
Nicole L. De La Mata ◽  
Patrick J. Kelly ◽  
Philip Masson ◽  
Emma O'Lone ◽  
...  
Author(s):  
Joanne Allen ◽  
Andy Towers ◽  
Fiona Alpass ◽  
Christine Stephens

ABSTRACTObjectiveLongitudinal cohort studies remain important sources of information in health and epidemiological research and represent a significant investment of resources. The maintenance of these cohorts over time and the representativeness of retained participants are important considerations for researchers. For those weighting the benefits of augmenting a longitudinal cohort study with data linkage to national health records, the potential for bias in consent and match rates and the utility of the newly obtained data are also key considerations. This study presents an analysis of bias associated with consent to participate and record matching in an established longitudinal cohort of older persons. We present the unique outcomes generated from this national health record data linkage project and the opportunities such variables present for longitudinal cohort studies.ApproachThe New Zealand Health, Work and Retirement study is a biennial survey of persons aged 55-85 which commenced in 2006. Over the past decade, additional cohorts have been recruited to the study, with n = 9003 older New Zealand residents participating to the year 2015. In 2013 the study began an approach to active survey participants for consent to link their longitudinal survey data to national health record data held by the New Zealand Health Information Service, including data related to hospital events, the New Zealand Cancer Registry, pharmaceutical data and mental health data. We compare self-reported longitudinal health trends associated with consent/declination to participate as well as for record match success and failure. Key outcomes derived from these national datasets for the purposes of the Health, Work and Retirement Study are described.ResultsConsent (62.5%) and declination (8.9%) to participate in the data linkage project are described in terms of the corresponding longitudinal self-reported health and socio-demographic trends for these groups. Successful and unsuccessful matches of participants to national health record data are also described. The calculation of outcomes from each of the linked datasets obtained and their potential utility in building upon existing longitudinal cohort data are also presented.ConclusionsNational health record data linkage presents a potentially valuable source of data to supplement and replicate findings related to health outcomes and expenditure derived from longitudinal cohort surveys. The challenges and successes of the New Zealand Health, Work and Retirement survey data linkage project touch upon considerations pertinent to evaluating the value of augmenting existing and ongoing longitudinal survey cohort for other researchers.


2015 ◽  
Vol 25 (5) ◽  
pp. 879-885 ◽  
Author(s):  
Lesley Graham ◽  
Colin M. Fischbacher ◽  
Diane Stockton ◽  
Andrew Fraser ◽  
Michael Fleming ◽  
...  

2021 ◽  
Vol 8 ◽  
pp. 205435812110222
Author(s):  
Reshma Shettigar ◽  
Ari Samaranayaka ◽  
John B. W. Schollum ◽  
Emma H. Wyeth ◽  
Sarah Derrett ◽  
...  

Background: Patient involvement in dialysis decision-making is crucial, yet little is known about patient-reported outcomes over time on dialysis. Objective: To examine health-related outcomes over 24 and 36 months in an older cohort of dialysis patients. Design: The “Dialysis outcomes in those aged ≥65 years study” is a prospective longitudinal cohort study of New Zealanders with kidney failure. Setting: Three New Zealand nephrology units. Patients: Kidney failure (dialysis and predialysis) patients aged 65 or above. We have previously described outcomes after 12 months of dialysis therapy relative to baseline. Measurements: Patient-reported social and health factors using the SF-36, EQ-5D, and Kidney Symptom Score questionnaires. Methods: This article describes and compares characteristics of 120 older kidney failure patients according to whether they report “Same/better” or “Worse” health 24 and 36 months later, and identifies predictors of “worse health.” Modified Poisson regression modeling estimated relative risks (RR) of worse health. Results: Of 120 patients at 12 months, 47.5% had worse health or had died by 24 months. Of those surviving at 24 months (n = 80), 40% had “Worse health” or had died at 36 months. Variables independently associated with reduced risk of “Worse health” (24 months) were as follows: Māori ethnicity (RR = 0.44; 95% CI = 0.26-0.75), Pacific ethnicity (RR = 0.39; 95% CI = 0.33-0.46); greater social satisfaction (RR = 0.57; 95% CI = 0.46-0.7). Variables associated with an increased risk of “Worse health” were as follows: problems with usual activities (RR = 1.32; 95% CI = 1.04-1.37); pain or discomfort (RR = 1.48; 95% CI = 1.34, 1.63). At 36 months, lack of sense of community (RR = 1.41; 95% CI = 1.18-1.69), 2 or more comorbidities (RR = 1.21; 95% CI = 1.13-1.29), and problems with poor health (RR = 1.47; 95% CI = 1.41-1.54) were associated with “Worse health.” Limitations: Participant numbers restricted the number of variables able to be included in the multivariable model, and hence there may have been insufficient power to detect certain associations. Conclusions: In this study, the majority of older dialyzing patients report “Same/better health” at 24 and 36 months. Māori and Pacific people report better outcomes on dialysis. Social and/or clinical interventions aimed at improving social satisfaction, sense of community, and help with usual activities may impact favorably on the experiences for older dialysis patients. Trial registration: Australian and New Zealand clinical trials registry: ACTRN12611000024943.


2020 ◽  
Vol 104 (S3) ◽  
pp. S225-S225
Author(s):  
James A. Hedley ◽  
Nicole De La Mata ◽  
Brenda M. Rosales ◽  
Karen M.J. Waller ◽  
Imogen K. Thomson ◽  
...  

2020 ◽  
Vol 104 (S3) ◽  
pp. S222-S223
Author(s):  
Brenda Marie Rosales ◽  
James Hedley ◽  
Karen Waller ◽  
Nicole De La Mata ◽  
Elena Cavazzoni ◽  
...  

2019 ◽  
Vol 104 (10) ◽  
pp. 2129-2138
Author(s):  
Nicole L. De La Mata ◽  
Patrick J. Kelly ◽  
Melanie Wyld ◽  
Philip Masson ◽  
Rustam Al-Shahi Salman ◽  
...  

2021 ◽  
pp. 101053952110411
Author(s):  
Maria E. Bellringer ◽  
Janet Pearson ◽  
Leon Iusitini

Pacific youth in New Zealand have a disproportionately high risk for gambling and gang involvement compared with New Zealand European youth. Limited evidence indicates that youth gang involvement is associated with problem gambling; no research shows if it is associated with gambling. We conducted exploratory secondary analyses of data from 1063 Pacific youth and their mothers using data from 2 time points (age 9 and 14 years) from a longitudinal cohort study. Gang involvement at age 9 years was significantly associated with gambling at age 14 years, with adjusted odds of 2.25 (95% CI = 1.16-4.37). Of confounders, having a mother with a partner and Cook Islands ethnicity appeared protective against gambling at age 14 years. Despite some study limitations, as youth gambling can lead to subsequent adult problem gambling, our findings highlight the importance of understanding why Pacific youth join gangs, to inform public health policies to reduce the potential for future development of harmful behaviors.


Author(s):  
Victor Khou ◽  
VictorNicole L De La Mat ◽  
Patrick J Kelly ◽  
Angela C Webster

IntroductionCardiovascular disease is a leading cause of death in patients with end-stage kidney disease (ESKD). However, ascertaining the impact of cardiovascular deaths has not been well characterised over long periods of follow-up and across different treatment states. Further insights into the lifetime risk of cardiovascular death are required to better inform clinical practice and economic planning. Objectives and ApproachWe performed a population-based cohort study on incident patients receiving ESKD treatment from the Australian and New Zealand Dialysis and Transplant registry (ANZDATA). Cardiac/vascular deaths were determined from ICD-10-AM codes listed in the underlying cause of death obtained via data linkage with the Australian National Death Index and New Zealand Mortality Collection database. We estimated mortality rates from cardiac/vascular death across time from ESKD treatment, and calculated probability of death and transplant status over time using multistate models. ResultsAcross 60,823 incident ESKD patients and 381,874 person-years of follow-up, 22% (7,551) of deaths were from cardiac/vascular disease. At 15 years from treatment, 15.6% of patients had died from cardiac/vascular causes, most of whom never received a transplant (13.6% vs 2.0% of cohort). Within the first year of dialysis, cardiac/vascular mortality was highest in the second month, at 3,632/100,000pys. Improvements in cardiac/vascular mortality with calendar year were only seen after 9 months of dialysis. Transplant recipients had consistently lower cardiac/vascular mortality rates (598/100,000 pys) compared to dialysis patients. However, comorbid cardiovascular disease was a risk factor for graft failure and death in transplant recipients (HR:1.52, 95% CI:1.42-1.62). Conclusion / ImplicationsDespite improvements in cardiac/vascular outcomes over time, cardiovascular death remains common in ESKD, particularly in the first few months of treatment. A greater focus on secondary prevention in earlier stages of chronic kidney disease may improve outcomes in new ESKD patients.


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