Search

Objective: Studies indicate that age-standardised heart failure (HF) incidence has been decreasing internationally; however, contrasting trends in different age groups have been reported, with rates increasing in younger people and decreasing in the elderly. We aimed to describe age-specific trends in HF incidence in New Zealand (NZ).Methods: In this nationwide data linkage study, we used routinely collected hospitalisation data to identify incident HF hospitalisations in NZ residents aged ≥20 years between 2006 and 2018. Age-specific and age-standardised incidence rates were calculated for each calendar year. Joinpoint regression was used to compare incidence trends.Results: 116 113 incident HF hospitalisations were identified over the 13-year study period. Between 2006 and 2013, age-standardised incidence decreased from 403 to 323 per 100 000 (annual percentage change (APC) -2.6%, 95% CI -3.6 to -1.6%). This reduction then plateaued between 2013 and 2018 (APC 0.8%, 95% CI -0.8 to 2.5%). Between 2006 and 2018, rates in individuals aged 20-49 years old increased by 1.5% per year (95% CI 0.3 to 2.7%) and decreased in those aged ≥80 years old by 1.2% per year (95% CI -1.7 to -0.7%). Rates in individuals aged 50-79 years old initially declined from 2006 to 2013, and then remained stable or increased from 2013 to 2018. The proportion of HF hospitalisations associated with ischaemic heart disease decreased from 35.1% in 2006 to 28.0% in 2018.Conclusion: HF remains an important problem in NZ. The decline in overall incidence has plateaued since 2013 due to increasing rates of HF in younger age groups despite an ongoing decline in the elderly. [ABSTRACT FROM AUTHOR]

Objective: To estimate the prevalence of hazards in the home environment that may contribute to unintentional falls among young and middle-aged New Zealanders. Methods: A random sample of 352 young and middle-aged people (25-60 years) residing in Auckland was drawn from the electoral roll. The prevalence of environmental factors that may have an impact on risk of falls was investigated using a structured interviewer-administered questionnaire. Results: Potential risk factors for falls were common in the study population (ladder use in the past year--64%; inability to reach a light from bed--21%; lack of handrails for stairs--54%). Only 9% and 11% of baths and showers, respectively, had grab or hand rails; 42% and 56% had anti-skid mats/surfaces. Compared to those reporting no socio-economic deprivation characteristics, respondents reporting one or more such characteristics were less likely to use a ladder and have indoor stairs, but more likely to have outdoors stairs. There was no significant relationship between socio-economic status and presence of a grab/handrail or antiskid mats/surfaces in or near showers/ baths. Conclusion and implications: Structural hazards that are likely to result in falls at home are common in New Zealand. The greater prevalence of some environmental risk factors for falls among the least socially deprived population may account for the inconsistent association between socio-economic deprivation and fall-related injuries reported in previous research. Information regarding the contribution of these and associated factors to the occurrence of falls can help target and reduce the risks involved. Key words: accidental falls, home accidents, risk factors, young adult, adult. Aust NZ J Public Health. 2010; 34:63-6 doi: 10.1111/j.1753-6405.2010.00475.x

Background: Permanent pacemaker (PPM) and implantable cardioverter defibrillator (ICD) implant rates have increased in New Zealand over the past decade. Aims: To provide a contemporary analysis of regional variation in implant rates. Methods: New PPM and ICD implants in patients aged ≥15 years were identified for 10 years (2009–2018) using procedure coding in the National Minimum Datasets, which collects all New Zealand public hospital admissions. Age‐standardised new implant rates per million adult population were calculated for each of the four regions (Northern, Midland, Central and Southern) and the 20 district health boards (DHB) across those regions. Trend analysis was performed using joinpoint regression. Results: New PPM implant rates increased nationally by 3.4%/year (P < 0.001). The Northern region had the highest new PPM implant rate, increasing by 4.5%/year (P < 0.001). Excluding DHB with <50 000 people, the new PPM implant rate for 2017/2018 was highest in Counties Manukau DHB (854.3/million; 95% confidence interval (CI): 774.9–933.6/million) and lowest in Canterbury DHB (488.6/million; 95% CI: 438.1–539.0/million). New ICD implant rates increased nationally by 3.0%/year (P = 0.002). The Midland region had the highest new ICD implant rate, increasing by 3.8%/year (P = 0.013). Excluding DHB with <50 000 people, the new ICD implant rate for 2017−2018 was highest in the Bay of Plenty DHB (228.5/million; 95% CI: 180.4–276.6/million) and lowest in Canterbury DHB (90.2/million; 95% CI: 69.9–110.4/million). Conclusion: There was significant variation in PPM and ICD implant rates across regions and DHB, suggesting potential inequity in patient access across New Zealand. [ABSTRACT FROM AUTHOR]