Background
Methods
Data source and study population
HA-VTE identification and covariates
Statistical analysis
Result
The distributions of study outcomes by patient and hospital characteristics
Characteristics | All Patients | HA-VTE | HA-VTE case fatality | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
N | (%) | n | (%) | IR | IRR | (95 % CI) | n | (%) | % | IRR | (95 % CI) | |||
Admission typea
| ||||||||||||||
Medical | 573,042 | (17.20 %) | 2,565 | (6.72 %) | 4.5 | 1.00 | 245 | (6.59 %) | 9.6 % | 1.00 | ||||
Surgical | 2,758,635 | (82.80 %) | 35,596 | (93.28 %) | 12.9 | 2.28 | (2.19–2.38) |
d
| 3,471 | (93.41 %) | 9.8 % | 1.05 | (0.91–1.20) | |
Sex | ||||||||||||||
Female | 1,693,109 | (50.82 %) | 19,805 | (51.90 %) | 11.7 | 1.00 | 1,730 | (46.56 %) | 8.7 % | 1.00 | ||||
Male | 1,638,568 | (49.18 %) | 18,356 | (48.10 %) | 11.2 | 0.93 | (0.91–0.95) |
d
| 1,986 | (53.44 %) | 10.8 % | 1.25 | (1.17–1.33) |
d
|
Age | ||||||||||||||
> =75 years & <90 | 1,074,206 | (32.24 %) | 15,350 | (40.22 %) | 14.3 | 1.00 | 1,832 | (49.30 %) | 11.9 % | 1.00 | ||||
> =18 years & <35 years | 396,444 | (11.90 %) | 1,742 | (4.56 %) | 4.4 | 0.53 | (0.50–0.56) |
d
| 55 | (1.48 %) | 3.2 % | 0.23 | (0.17–0.30) |
d
|
> =35 years & <55 years | 707,274 | (21.23 %) | 5,612 | (14.71 %) | 7.9 | 0.83 | (0.81–0.86) |
d
| 354 | (9.53 %) | 6.3 % | 0.47 | (0.41–0.52) |
d
|
> =55 years & <75 years | 1,153,753 | (34.63 %) | 15,457 | (40.50 %) | 13.4 | 1.13 | (1.10–1.15) |
d
| 1,475 | (39.69 %) | 9.5 % | 0.77 | (0.72–0.83) |
d
|
Marital status | ||||||||||||||
Married | 1,803,208 | (54.12 %) | 20,814 | (54.54 %) | 11.5 | 1.00 | 2,089 | (56.22 %) | 10.0 % | 1.00 | ||||
Single | 1,372,496 | (41.20 %) | 15,730 | (41.22 %) | 11.5 | 0.90 | (0.89–0.92) |
d
| 1,447 | (38.94 %) | 9.2 % | 0.91 | (0.85–0.98) |
c
|
Unknown | 155,973 | (4.68 %) | 1,617 | (4.24 %) | 10.4 | 0.83 | (0.79–0.88) |
d
| 180 | (4.84 %) | 11.1 % | 1.12 | (0.96–1.31) | |
Country of birth | ||||||||||||||
Australia and New Zealand | 2,411,315 | (72.38 %) | 26,794 | (70.21 %) | 11.1 | 1.00 | 2,575 | (69.29 %) | 9.6 % | 1.00 | ||||
UK, US & Canada | 223,710 | (6.71 %) | 2,873 | (7.53 %) | 12.8 | 1.01 | (0.97–1.05) | 271 | (7.29 %) | 9.4 % | 0.90 | (0.79–1.02) | ||
Non-English Europe | 317,973 | (9.54 %) | 4,546 | (11.91 %) | 14.3 | 0.98 | (0.95–1.02) | 493 | (13.27 %) | 10.8 % | 0.98 | (0.88–1.08) | ||
North Africa | 61,595 | (1.85 %) | 487 | (1.28 %) | 7.9 | 0.67 | (0.61–0.73) |
d
| 47 | (1.26 %) | 9.7 % | 1.09 | (0.82–1.46) | |
Asia | 101,485 | (3.05 %) | 996 | (2.61 %) | 9.8 | 0.76 | (0.71–0.81) |
d
| 98 | (2.64 %) | 9.8 % | 1.11 | (0.90–1.36) | |
Others | 215,599 | (6.47 %) | 2,465 | (6.46 %) | 11.4 | 0.94 | (0.90–0.98) |
d
| 232 | (6.24 %) | 9.4 % | 1.01 | (0.88–1.16) | |
Quartiles of SEIFA | ||||||||||||||
1st quartile (most disadvantaged) | 913,712 | (27.42 %) | 9,482 | (24.85 %) | 10.4 | 1.00 | 939 | (25.27 %) | 9.9 % | 1.00 | ||||
2nd quartile (disadvantaged) | 862,580 | (25.89 %) | 8,843 | (23.17 %) | 10.3 | 1.00 | (0.97–1.03) | 900 | (24.22 %) | 10.2 % | 1.05 | (0.95–1.16) | ||
3rd quartile (advantaged) | 827,343 | (24.83 %) | 9,701 | (25.42 %) | 11.7 | 0.98 | (0.95–1.01) | 1,011 | (27.21 %) | 10.4 % | 1.12 | (1.01–1.23) |
c
| |
4th quartile (most advantaged) | 728,042 | (21.85 %) | 10,135 | (26.56 %) | 13.9 | 0.99 | (0.95–1.03) | 866 | (23.30 %) | 8.5 % | 1.13 | (1–1.27) |
c
| |
Length of stay | ||||||||||||||
2–4 days | 1,495,477 | (44.89 %) | 4,803 | (12.59 %) | 3.2 | 1.00 | 567 | (15.26 %) | 11.8 % | 1.00 | ||||
4–9 days | 1,056,167 | (31.70 %) | 10,724 | (28.10 %) | 10.2 | 2.78 | (2.69–2.88) |
d
| 816 | (21.96 %) | 7.6 % | 0.69 | (0.62–0.76) |
d
|
Over 10 days | 780,033 | (23.41 %) | 22,634 | (59.31 %) | 29.0 | 7.91 | (7.65–8.17) |
d
| 2,333 | (62.78 %) | 10.3 % | 0.82 | (0.74–0.90) |
d
|
Major principal diagnostic diseasesb
| ||||||||||||||
Cardiac arrhythmias | 74,686 | (2.24 %) | 657 | (1.72 %) | 8.8 | - | 22 | (0.59 %) | 3.3 % | - | ||||
Chronic pulmonary disease | 129,030 | (3.87 %) | 853 | (2.24 %) | 6.6 | - | 92 | (2.48 %) | 10.8 % | - | ||||
Coagulopathy | 5,455 | (0.16 %) | 211 | (0.55 %) | 38.7 | - | 15 | (0.40 %) | 7.1 % | - | ||||
Congestive heart failure | 71,705 | (2.15 %) | 971 | (2.54 %) | 13.5 | - | 130 | (3.50 %) | 13.4 % | - | ||||
Diabetes with chronic complication | 41,956 | (1.26 %) | 464 | (1.22 %) | 11.1 | - | 58 | (1.56 %) | 12.5 % | - | ||||
Malignancies | 206,407 | (6.20 %) | 3,796 | (9.95 %) | 18.4 | - | 860 | (23.14 %) | 22.7 % | - | ||||
Metastatic solid tumour | 49,332 | (1.48 %) | 1,427 | (3.74 %) | 28.9 | - | 368 | (9.90 %) | 25.8 % | - | ||||
Peripheral vascular disease | 26,225 | (0.79 %) | 425 | (1.11 %) | 16.2 | - | 61 | (1.64 %) | 14.4 % | - | ||||
Pulmonary circulation disorders | 1,520 | (0.05 %) | 73 | (0.19 %) | 48.0 | - | 10 | (0.27 %) | 13.7 % | - | ||||
Renal disease | 8,736 | (0.26 %) | 103 | (0.27 %) | 11.8 | - | 14 | (0.38 %) | 13.6 % | - | ||||
Rheumatic disease | 9,811 | (0.29 %) | 176 | (0.46 %) | 17.9 | - | 9 | (0.24 %) | 5.1 % | - | ||||
Hospital type | ||||||||||||||
Public | 2,704,301 | (81.17 %) | 31,160 | (81.65 %) | 11.5 | 1.00 | 3,362 | (90.47 %) | 10.8 % | 1.00 | ||||
Private | 627,376 | (18.83 %) | 7,001 | (18.35 %) | 11.2 | 1.03 | (0.85–1.25) | 354 | (9.53 %) | 5.1 % | 0.55 | (0.43–0.71) |
d
| |
Peer hospital groups-Public | ||||||||||||||
Principal referral (A1) | 1,315,038 | (48.63 %) | 19,134 | (61.41 %) | 14.6 | 1.00 | 2,069 | (61.54 %) | 10.8 % | 1.00 | ||||
Ungrouped acute (A3) | 73,569 | (2.72 %) | 765 | (2.46 %) | 10.4 | 0.67 | (0.46–0.95) |
c
| 132 | (3.93 %) | 17.3 % | 2.71 | (1.48–4.97) |
d
|
Major metro- & non-metropolitan (B) | 839,827 | (31.06 %) | 7,958 | (25.54 %) | 9.5 | 0.73 | (0.60–0.89) |
d
| 817 | (24.30 %) | 10.3 % | 1.22 | (0.91–1.64) | |
District group 1 (C1) | 245,005 | (9.06 %) | 1,933 | (6.20 %) | 7.9 | 0.64 | (0.51–0.81) |
d
| 198 | (5.89 %) | 10.2 % | 1.75 | (1.22–2.50) |
d
|
District group 2 (C2) | 230,862 | (8.54 %) | 1,370 | (4.40 %) | 5.9 | 0.48 | (0.39–0.60) |
d
| 146 | (4.34 %) | 10.7 % | 2.06 | (1.44–2.95) |
d
|
Peer hospital groups-Private | ||||||||||||||
Major m | 409,555 | (65.28 %) | 4,961 | (70.86 %) | 12.1 | 1.00 | 213 | (60.17 %) | 4.3 % | 1.00 | ||||
District (22) | 217,821 | (34.72 %) | 2,040 | (29.14 %) | 9.4 | 1.03 | (0.64–1.64) | 141 | (39.83 %) | 6.9 % | 1.36 | (0.79–2.34) | ||
Local health district | ||||||||||||||
Metropolitan | 2,300,073 | (69.04 %) | 29,779 | (78.04 %) | 12.9 | 1.00 | 2,814 | (75.73 %) | 9.4 % | 1.00 | ||||
Rural & Regional NSW | 1,031,604 | (30.96 %) | 8,382 | (21.96 %) | 8.1 | 0.69 | (0.59–0.81) |
d
| 902 | (24.27 %) | 10.8 % | 1.18 | (0.95–1.45) | |
Total | 3,331,677 | 38,161 | 11.4 | 3,716 | 9.7 % |
The trends of HA-VTE incidence rate and HA-VTE case fatality over the study period
The variation of outcomes between and with hospital peer groups stratified by patients types (medical versus surgical)
Hospital peer group | Hospital | HA-VTE | HA-VTE case fatality | Correlation coefficient | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
n | Lowest (IR) | Highest (IR) | IRR (95 % CI) | Lowest (%) | Highest (%) | IRR (95 % CI) | (95 % CI) | |||||||
All admissions | ||||||||||||||
Public hospitals | ||||||||||||||
Principal referral (A1) | 17 | 11.0 | 22.9 | 2.09 | (2–2.19) |
b
| 7.7 % | 13.8 % | 1.93 | (1.64–2.27) |
b
| −0.38 | (-0.76–0.19) | |
Major metro- & non-metropolitan (B) | 22 | 6.8 | 12.6 | 1.70 | (1.58–1.84) |
b
| 6.9 % | 15.0 % | 2.13 | (1.73–2.63) |
b
| −0.22 | (-0.59–0.22) | |
District group 1 (C1) | 13 | 5.8 | 11.7 | 2.02 | (1.77–2.31) |
b
| 5.9 % | 20.5 % | 3.77 | (2.41–5.91) |
b
| −0.35 | (-0.76–0.25) | |
District group 2 (C2) | 30 | 2.8 | 10.4 | 2.94 | (2.39–3.62) |
b
| 4.7 % | 14.7 % | 3.47 | (1.94–6.19) |
b
| 0.04 | (-0.33–0.39) | |
Private hospitals | ||||||||||||||
Major (21) | 10 | 4.0 | 24.7 | 5.33 | (4.62–6.16) |
b
| 1.4 % | 10.5 % | 6.23 | (4.25–9.13) |
b
| −0.63 | (-0.9–0.01) |
a
|
District (22) | 12 | 6.0 | 14.3 | 2.44 | (2.05–2.9) |
b
| 2.8 % | 12.3 % | 5.72 | (3.1–10.58) |
b
| −0.82 | (-0.95–0.46) |
b
|
Medical admissions | ||||||||||||||
Public hospitals | ||||||||||||||
Principal referral (A1) | 17 | 3.3 | 7.6 | 2.24 | (1.75–2.87) |
b
| 1.3 % | 18.3 % | 15.65 | (3.73–65.58) |
b
| −0.08 | (-0.61–0.49) | |
Major metro- & non-metropolitan (B) | 22 | 2.3 | 4.5 | 2.03 | (1.59–2.58) |
b
| 0.0 % | 20.1 % | 0.29 | (-0.15–0.63) | ||||
District group 1 (C1) | 13 | 1.5 | 5.5 | 4.32 | (2.72–6.86) |
b
| 4.0 % | 20.0 % | 5.81 | (1.58–21.41) |
b
| −0.36 | (-0.76–0.23) | |
District group 2 (C2) | 30 | 2.3 | 7.0 | 3.65 | (2.64–5.06) |
b
| 0.0 % | 27.8 % | −0.13 | (-0.47–0.24) | ||||
Private hospitals | ||||||||||||||
Major (21) | 10 | 5.1 | 13.6 | 2.52 | (1.48–4.29) |
b
| 1.1 % | 20.0 % | 0.32 | (-0.39–0.79) | ||||
District (22) | 12 | 3.6 | 12.9 | 3.88 | (2.55–5.92) |
b
| 4.6 % | 16.7 % | 2.57 | (0.66–9.97) | −0.67 | (-0.9–0.16) |
a
| |
Surgical admissions | ||||||||||||||
Public hospitals | ||||||||||||||
Principal referral (A1) | 17 | 11.8 | 25.0 | 2.12 | (2.02–2.22) |
b
| 8.9 % | 14.0 % | 1.74 | (1.52–1.99) |
b
| −0.38 | (-0.76–0.19) | |
Major metro- & non-metropolitan (B) | 22 | 7.9 | 14.3 | 1.74 | (1.61–1.88) |
b
| 7.2 % | 14.7 % | 2.01 | (1.62–2.49) |
b
| −0.21 | (-0.58–0.23) | |
District group 1 (C1) | 13 | 7.2 | 13.7 | 1.88 | (1.63–2.16) |
b
| 5.8 % | 20.8 % | 4.11 | (2.5–6.75) |
b
| −0.30 | (-0.73–0.3) | |
District group 2 (C2) | 30 | 2.9 | 14.7 | 3.75 | (2.83–4.98) |
b
| 3.8 % | 14.9 % | 4.37 | (2.06–9.26) |
b
| 0.05 | (-0.32–0.4) | |
Private hospitals | ||||||||||||||
Major (21) | 10 | 3.6 | 25.0 | 6.07 | (5.2–7.09) |
b
| 1.7 % | 11.2 % | 5.88 | (3.77–9.18) |
b
| −0.36 | (-0.81–0.35) | |
District (22) | 12 | 5.9 | 11.8 | 2.37 | (1.99–2.81) |
b
| 2.2 % | 11.3 % | 6.88 | (3.24–14.62) |
b
| −0.72 | (-0.92–0.25) |
b
|