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Volume 30, Number 1—January 2024
Dispatch

Excess Deaths Associated with Rheumatic Heart Disease, Australia, 2013–2017

Ingrid StaceyComments to Author , Rebecca Seth, Lee Nedkoff, Vicki Wade, Emma Haynes, Jonathan Carapetis, Joseph Hung, Kevin Murray, Dawn Bessarab, and Judith Katzenellenbogen
Author affiliations: The University of Western Australia, Perth, Western Australia, Australia (I. Stacey, L. Nedkoff, E. Haynes, J. Carapetis, J. Hung, K. Murray, D. Bessarab, J. Katzenellenbogen); Curtin University, Perth, Western Australia (R. Seth); Victor Chang Cardiac Research Institute, Darlinghurst, New South Wales, Australia (L. Nedkoff); National Heart Foundation of Australia, East Sydney, New South Wales, Australia (V. Wade); Telethon Kids Institute, Nedlands, Western Australia, Australia (J. Carapetis, J. Katzenellenbogen)

Main Article

Table

Mortality rates associated with RHD among persons <65 years of age, Australia, 2103–2017*

Age group, y Indigenous
 Non-Indigenous
 Rate ratio (95% CI)
No. Rate (95% CI) No. Rate (95% CI)
Background mortality rates†
0–24 1,319 70.4 (66.7–74.4) 8282 32.6 (32.0 –33.4) 2.16 (2.03–2.29)
25–44 2,302 262.87 (252.2–273.8) 17,004 74.20 (73.1– 75.3) 3.54 (3.29–3.60)
45–64 5,221 921.66 (896.8 –947.0) 69,752 344.26 (341.7–346.8) 2.68 (2.60–2.75)
Crude, 0–64 8,842 266.83 (261.3– 272.4) 95,038 138.64 (137.8–139.5) 1.92 (1.88–1.97)
ASMR, 0–64
 8,842
 193.55 (189.5– 197.6)
95,038
 72.29 (71.8– 72.7)
2.68 (2.66–2.70)
Observed mortality rates‡
0–24 13 204.1 (93.2–315.1) <5 339.4 (0–723.4) NC
25–44 112 1,238.3 (1,009.0–1,467.7) 34 858.4 (569.8–1,146.9) 1.44 (0.98–2.12)
45–64 276 4,568.6 (4,029.6–5,107.6) 288 2,140.1 (1,892.9–2,387.3) 2.13 (1.81–2.52)
Crude, 0–64 401 1,869.1 (1,687.9–2,050.4) 325 1,775.7 (1,584.4–1,967.1) 1.05 (0.91–1.22)
ASMR, 0–64
 401
 1,451.6 (1,307.0–1,596.2)
325
 883.6 (674.3–1,092.9)
1.64 (1.42–1.9)
Excess mortality rates§
0–24 9¶ 136.7 (39.3–249.0) <5¶ 308.40 (0–751.3) NC
25–44 88¶ 1,000.2 (786.4–1230.9) 29¶ 760.7 (487.8–1,047.3) 1.31 (1.02–2.31)
45–64 222¶ 3,720.4 (3,184.8–4305.8) 240¶ 1,817.8 (1,566.9–2,066.8) 2.05 (1.81–2.5)
Crude, 0–64 319¶ 1,636.7 (1,459.8–1822.1) 272¶ 1,646.7 (1,454.5–1,847.4) 0.99 (0.85–1.16)
ASMR, 0–64
 319¶
 1,166.0 (1,028.8–1317.6)
272¶
 770.8 (584.3–989.0)
1.51 (1.14–2.02)
ABS RHD-coded mortality rates#
0–24 8 0.43 (0.13–0.72) 7 0.03 (0.01–0.05) 15.49 (5.62–42.71)
25–44 48 5.48 (3.93–7.03) 41 0.18 (0.12–0.23) 30.64 (20.19–46.48)
45–64 89 15.71 (12.45–18.98) 252 1.24 (1.09–1.40) 12.63 (9.92–16.09)
Crude, 0–64 145 4.38 (3.66–5.09) 300 0.44 (0.39–0.49) 10.00 (8.20–12.19)
ASMR, 0–64 145 5.25 (4.40–6.11) 300 0.33 (0.29–0.37) 15.85 (13.00–19.33)

*Rates are deaths/100,000 person-years; intervals for excess mortality rates were obtained from bootstrapping of estimates (interpreted as 95% CIs). ABS, Australian Bureau of Statistics; ASMR, age-standardized mortality rate; NC, not calculated (numbers too low for reliable estimate); RHD, rheumatic heart disease. †Population level, n = 14,372,851. ‡Deaths from all causes within the RHD study cohort (n = 9,342). §Observed mortality rates minus background mortality rates. ¶Expected number of deaths associated with RHD were calculated on the basis of excess mortality rate applied to person-years within appropriate age/population strata. #Whole population. Previously published data, reproduced with permission (2). Population-level mortality rates based on ABS RHD-coded data (RHD as an underlying or associated cause of death).

Main Article

References
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