Cannon, Jeffrey; Roberts, Kathryn; Milne, Catherine; Carapetis, Jonathan R

Author(s)

Cannon, Jeffrey

Roberts, Kathryn

Milne, Catherine

Carapetis, Jonathan R

Publication Date

2017-03-02

Abstract

Rheumatic heart disease (RHD) remains a disease of international importance, yet little has been published about disease progression in a contemporary patient cohort. Multi-state models provide a well-established method of estimating rates of transition between disease states, and can be used to evaluate the cost-effectiveness of potential interventions. We aimed to create a multi-state model for RHD progression using serial clinical data from a cohort of Australian patients. The Northern Territory RHD register was used to identify all Indigenous residents diagnosed with RHD between the ages of 5 and 24 years in the time period 1999-2012. Disease severity over time, surgeries, and deaths were evaluated for 591 patients. Of 96 (16.2%) patients with severe RHD at diagnosis, 50% had proceeded to valve surgery by 2 years, and 10% were dead within 6 years. Of those diagnosed with moderate RHD, there was a similar chance of disease regression or progression over time. Patients with mild RHD at diagnosis were the most stable, with 64% remaining mild after 10 years; however, 11.4% progressed to severe RHD and half of these required surgery. The prognosis of young Indigenous Australians diagnosed with severe RHD is bleak; interventions must focus on earlier detection and treatment if the observed natural history is to be improved. This multi-state model can be used to predict the effect of different interventions on disease progression and the associated costs.

Citation

Journal of the American Heart Association 2017-03-02; 6(3)

Pubmed ID

https://pubmed.ncbi.nlm.nih.gov/28255075/?otool=iaurydwlib

Link

https://hdl.handle.net/10137/5275

Subject

pediatric

prognosis

rheumatic heart disease

MESH subject

Adolescent

Australia

Cardiac Valve Annuloplasty

Child

Child, Preschool

Cohort Studies

Disease Progression

Female

Follow-Up Studies

Heart Valve Prosthesis Implantation

Humans

Male

Northern Territory

Prognosis

Rheumatic Heart Disease

Severity of Illness Index

Young Adult

Oceanic Ancestry Group

Title

Rheumatic Heart Disease Severity, Progression and Outcomes: A Multi-State Model.

Type of document

Journal Article

Entity Type

Publication

Author(s)	Cannon, Jeffrey Roberts, Kathryn Milne, Catherine Carapetis, Jonathan R
Publication Date	2017-03-02
Abstract	Rheumatic heart disease (RHD) remains a disease of international importance, yet little has been published about disease progression in a contemporary patient cohort. Multi-state models provide a well-established method of estimating rates of transition between disease states, and can be used to evaluate the cost-effectiveness of potential interventions. We aimed to create a multi-state model for RHD progression using serial clinical data from a cohort of Australian patients. The Northern Territory RHD register was used to identify all Indigenous residents diagnosed with RHD between the ages of 5 and 24 years in the time period 1999-2012. Disease severity over time, surgeries, and deaths were evaluated for 591 patients. Of 96 (16.2%) patients with severe RHD at diagnosis, 50% had proceeded to valve surgery by 2 years, and 10% were dead within 6 years. Of those diagnosed with moderate RHD, there was a similar chance of disease regression or progression over time. Patients with mild RHD at diagnosis were the most stable, with 64% remaining mild after 10 years; however, 11.4% progressed to severe RHD and half of these required surgery. The prognosis of young Indigenous Australians diagnosed with severe RHD is bleak; interventions must focus on earlier detection and treatment if the observed natural history is to be improved. This multi-state model can be used to predict the effect of different interventions on disease progression and the associated costs.
Citation	Journal of the American Heart Association 2017-03-02; 6(3)
Pubmed ID	https://pubmed.ncbi.nlm.nih.gov/28255075/?otool=iaurydwlib
Link	https://hdl.handle.net/10137/5275
Subject	pediatric prognosis rheumatic heart disease
MESH subject	Adolescent Australia Cardiac Valve Annuloplasty Child Child, Preschool Cohort Studies Disease Progression Female Follow-Up Studies Heart Valve Prosthesis Implantation Humans Male Northern Territory Prognosis Rheumatic Heart Disease Severity of Illness Index Young Adult Oceanic Ancestry Group
Title	Rheumatic Heart Disease Severity, Progression and Outcomes: A Multi-State Model.
Type of document	Journal Article
Entity Type	Publication

Rheumatic Heart Disease Severity, Progression and Outcomes: A Multi-State Model.

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