Taking the Pulse of Timor-Leste's Cardiac Needs: a Ten-Year Descriptive Time Trend Analysis.

Background: The East Timor Hearts Fund (ETHF) is a charitable organisation involving Australian cardiologists providing outreach screening and cardiac interventions. Method(s): The ETHF database was sectioned into two-year intervals (2009/10, 2011/12, 2013/14, 2015/16, 2017/18). Patient demographics and clinical outcomes were compared to assess temporal change, with subgroup analysis of adult (>18 years old), paediatric and interventional patients. Result(s): Over 10 years, 2,050 patient encounters have occurred. ETHF reviewed 14 times as many patients in 2017/18 as in 2009/10 (1,119 vs 80 patients). Rheumatic and congenital cardiac disease remain very common (39.1% of adult and 74.2% of paediatric new patients), with 1.4% of new patients exhibiting both pathologies simultaneously. Amongst adult patients, median age and proportion of male patients are rising (p < 0.0001). The number of new patients identified with serious rheumatic or congenital heart disease tripled in 2017/18 compared to 2009/10 (99 vs 34 patients, respectively, p < 0.0001). Paediatric case volume has increased over ten-fold (288 new patients in 2017/18 vs 24 in 2009/10, p < 0.0001), with corresponding increase in proportion of paediatric interventions (59.4% in 2017/18 vs 25.0% in 2009/10, p = 0.027). Patients undergoing intervention (n = 87) have extremely low post-procedural complications and mortality (3.4% and 1.1%, respectively), and 100% of eligible patients attend at least one post-procedure appointment. Conclusion(s): Timorese demand for cardiac services has grown exponentially over the decade, with half ETHF's clinical volume undertaken in the most recent two-year period. Patient demographics are altering over time and an increasing number of interventions are being conducted, with excellent outcomes and patient follow-up.Copyright © 2019