Combined Universities Centre for Rural Health, PO Box 109, Geraldton, WA 6531, Australia.
BMC Cardiovasc Disord. 2012 Nov 1;12:99. doi: 10.1186/1471-2261-12-99.
Cardiovascular diseases contribute substantially to the poor health and reduced life expectancy of Indigenous Australians. Heart failure is a common, disabling, progressive and costly complication of these disorders. The epidemiology of heart failure and the adequacy of relevant health service provision in Indigenous Australians are not well delineated.
A systematic search of the electronic databases PubMed, Embase, Web of Science, Cinahl Plus, Informit and Google Scholar was undertaken in April 2012 for peer-reviewed journal articles relevant to the topic of heart failure in Indigenous Australians. Additionally, a website search was done to identify other pertinent publications, particularly government reports.
There was a paucity of relevant peer-reviewed research, and government reports dominated the results. Ten journal articles, 1 published conference abstract and 10 reports were eligible for inclusion. Indigenous Australians reportedly have higher morbidity and mortality from heart failure than their non-Indigenous counterparts (age-standardised prevalence ratio 1.7; age-standardised hospital separation ratio ≥3; crude per capita hospital expenditure ratio 1.58; age-adjusted mortality ratio >2). Despite the evident disproportionate burden of heart failure in Indigenous Australians, the accuracy of estimation from administrative data is limited by poor indigenous identification, inadequate case ascertainment and exclusion of younger subjects from mortality statistics. A recent journal article specifically documented a high prevalence of heart failure in Central Australian Aboriginal adults (5.3%), noting frequent undiagnosed disease. One study examined barriers to health service provision for Indigenous Australians in the context of heart failure.
Despite the shortcomings of available published data, it is clear that Indigenous Australians have an excess burden of heart failure. Emerging data suggest that undiagnosed cases may be common in this population. In order to optimise management and to inform policy, high quality research on heart failure in Indigenous Australians is required to delineate accurate epidemiological indicators and to appraise health service provision.
心血管疾病对澳大利亚原住民的健康状况和预期寿命造成了严重影响。心力衰竭是这些疾病常见的、使人丧失能力的、进行性的且代价高昂的并发症。心力衰竭在澳大利亚原住民中的流行病学情况以及相关卫生服务的提供情况尚不清楚。
我们于 2012 年 4 月对与澳大利亚原住民心力衰竭相关的同行评议期刊文章进行了系统检索，检索的电子数据库包括 PubMed、Embase、Web of Science、Cinahl Plus、Informit 和 Google Scholar。此外，还进行了网站搜索以确定其他相关出版物，特别是政府报告。
相关的同行评议研究很少，政府报告占据主导地位。有 10 篇期刊文章、1 篇会议摘要和 10 份报告符合纳入标准。据报道，澳大利亚原住民心力衰竭的发病率和死亡率高于非原住民（年龄标准化患病率比为 1.7；年龄标准化住院分离率≥3；人均住院支出比为 1.58；年龄调整死亡率比>2）。尽管心力衰竭对澳大利亚原住民的负担明显不成比例，但由于土著身份识别不准确、病例发现不足以及将年轻患者排除在死亡率统计之外，从行政数据中进行准确估计的准确性受到限制。最近的一篇期刊文章专门记录了澳大利亚中部地区原住民成年人心力衰竭的高患病率（5.3%），并指出该疾病常常未被诊断。有一项研究在心力衰竭的背景下检查了向澳大利亚原住民提供卫生服务的障碍。
尽管现有发表数据存在缺陷，但很明显，澳大利亚原住民心力衰竭的负担过重。新出现的数据表明，该人群中可能有未确诊的病例。为了优化管理并为政策提供信息，需要对澳大利亚原住民心力衰竭进行高质量的研究，以确定准确的流行病学指标并评估卫生服务的提供情况。
