Department of Cardiology, Middlemore Hospital, Auckland, New Zealand.
Department of Cardiology, Waikato Hospital, Hamilton, New Zealand.
Intern Med J. 2022 Jun;52(6):1035-1047. doi: 10.1111/imj.15165. Epub 2022 May 31.
Permanent pacemaker (PPM) and implantable cardioverter defibrillator (ICD) implant rates have increased in New Zealand over the past decade.
To provide a contemporary analysis of regional variation in implant rates.
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.
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).
There was significant variation in PPM and ICD implant rates across regions and DHB, suggesting potential inequity in patient access across New Zealand.
在过去的十年中，永久性心脏起搏器 (PPM) 和植入式心脏复律除颤器 (ICD) 的植入率在新西兰有所增加。
提供区域内植入率变化的最新分析。
使用国家最小数据集（National Minimum Datasets）中的程序编码，确定了 10 年来年龄≥15 岁的新 PPM 和 ICD 植入患者，该数据集收集了所有新西兰公立医院的入院信息。计算了每个区域（北部、米德兰、中部和南部）和该地区的 20 个地区卫生局 (DHB) 每百万成年人口的年龄标准化新植入率。使用连接点回归进行趋势分析。
全国范围内新 PPM 植入率每年增长 3.4%（P < 0.001）。北部地区的新 PPM 植入率最高，每年增长 4.5%（P < 0.001）。排除人口少于 50,000 人的 DHB，2017/2018 年 Counties Manukau DHB 的新 PPM 植入率最高（854.3/百万；95%置信区间 (CI)：774.9-933.6/百万），而 Canterbury DHB 最低（488.6/百万；95% CI：438.1-539.0/百万）。全国范围内新 ICD 植入率每年增长 3.0%（P = 0.002）。米德兰地区的新 ICD 植入率最高，每年增长 3.8%（P = 0.013）。排除人口少于 50,000 人的 DHB，2017/2018 年 Bay of Plenty DHB 的新 ICD 植入率最高（228.5/百万；95% CI：180.4-276.6/百万），而 Canterbury DHB 最低（90.2/百万；95% CI：69.9-110.4/百万）。
PPM 和 ICD 植入率在各地区和 DHB 之间存在显著差异，表明新西兰各地患者获得机会存在潜在不平等。
