Department of Cardiology, Concord Hospital, The University of Sydney, Concord, NSW, Australia.
PLoS One. 2022 Aug 10;17(8):e0272305. doi: 10.1371/journal.pone.0272305. eCollection 2022.
Whether a bias exists in the implantation of permanent pacemakers (PPI) and complications according to sex and age in the Australian population is unclear.
Population rate of PPI and its complications differed between men and women.
We examined the prevalence of PPI from January-2009 to December-2018 from datasets held by the New South Wales (NSW) Centre-for-Health-Record-Linkage, including patient's characteristics and in-hospital complications. All analysis was stratified by sex and age by decade.
A total of 28,714 admissions involved PPI (40% women). The mean PPI rate (±standard-deviation) and median age (interquartile range) was 2,871±242 per-annum and 80yrs (73-86yrs), respectively. At the same time-period, the mean NSW population size was 7,487,393±315,505 persons (50% women; n = 3,773,756±334,912). The mean annual age-adjusted rate of PPI was 125.5±11.6 per-100,000-men, compared to 63.4±14.3 per-100,000-women (P<0.01). The mean annual rate of PPI increased from 2009-2017 by 0.9±3.3% in men, compared to 0.4±4.4% in women (P<0.01) suggesting a widening disparity. Total non-fatal in-hospital complications was higher in women compared to men (8.2% vs 6.6%, P<0.01), and this persisted throughout study period even after adjusting for multiple covariates. Overall, in-hospital mortality was low (0.73%) and similar between sexes.
In a statewide Australian population exceeding 7 million, PPI rates were consistently nearly two-fold higher for men compared to women over 10-years, with an apparently widening disparity, that was not explained by age. Overall complication rates were higher in women. Future studies should examine the aetiology behind this disparity in PPI rates, as well as its complications.
在澳大利亚人群中，永久性心脏起搏器 (PPI) 的植入和并发症是否存在性别和年龄差异尚不清楚。
PPI 及其并发症在男性和女性之间的人群发生率不同。
我们从新南威尔士州 (NSW) 健康记录链接中心保存的数据集检查了 2009 年 1 月至 2018 年 12 月期间的 PPI 患病率，包括患者特征和住院期间的并发症。所有分析均按性别和年龄每十年分层。
共有 28714 例 PPI 入院（40%为女性）。平均 PPI 率（±标准差）和中位年龄（四分位距）分别为每年 2871±242 例和 80 岁（73-86 岁）。同时，同期 NSW 人口规模平均为 7487393±315505 人（50%为女性；n = 3773756±334912）。每年每 10 万人中男性的年龄调整后 PPI 发生率为 125.5±11.6 例，而女性为 63.4±14.3 例（P<0.01）。2009-2017 年，男性 PPI 的年平均增长率为 0.9±3.3%，而女性为 0.4±4.4%（P<0.01），表明差异逐渐扩大。与男性相比，女性的总非致命性院内并发症发生率更高（8.2%比 6.6%，P<0.01），即使在调整了多个协变量后，这种情况在整个研究期间仍然存在。总体而言，院内死亡率较低（0.73%），男女之间相似。
在一个超过 700 万人口的全州范围内，男性 PPI 率在 10 年内几乎是女性的两倍，差异明显扩大，这不能用年龄来解释。女性的总体并发症发生率更高。未来的研究应该检查 PPI 率差异背后的病因以及并发症。
