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dc.contributor.authorKhou, Victor
dc.contributor.authorAnderson, James J
dc.contributor.authorStrange, Geoff
dc.contributor.authorCorrigan, Carolyn
dc.contributor.authorCollins, Nicholas
dc.contributor.authorCelermajer, David S
dc.contributor.authorDwyer, Nathan
dc.contributor.authorFeenstra, John
dc.contributor.authorHorrigan, Mark
dc.contributor.authorKeating, Dominic
dc.contributor.authorKotlyar, Eugene
dc.contributor.authorLavender, Melanie
dc.contributor.authorMcWilliams, Tanya J
dc.contributor.authorSteele, Peter
dc.contributor.authorWeintraub, Robert
dc.contributor.authorWhitford, Helen
dc.contributor.authorWhyte, Ken
dc.contributor.authorWilliams, Trevor J
dc.contributor.authorWrobel, Jeremy P
dc.contributor.authorKeogh, Anne
dc.contributor.authorLau, Edmund M
dc.date.accessioned2020-02-10T02:23:32Z
dc.date.available2020-02-10T02:23:32Z
dc.date.issued2020
dc.identifier.issn1323-7799
dc.identifier.doi10.1111/resp.13768
dc.identifier.urihttp://hdl.handle.net/10072/391263
dc.description.abstractBackground and objective: Early diagnosis of PAH is clinically challenging. Patterns of diagnostic delay in Australian and New Zealand PAH populations have not been explored in large-scale studies. We aimed to evaluate the magnitude, risk factors and survival impact of diagnostic delay in Australian and New Zealand PAH patients. Methods: A cohort study of PAH patients from the PHSANZ Registry diagnosed from 2004 to 2017 was performed. Diagnostic interval was the time from symptom onset to diagnostic right heart catheterization as recorded in the registry. Factors associated with diagnostic delay were analysed in a multivariate logistic regression model. Survival rates were compared across patients based on the time to diagnosis using Kaplan-Meier method and Cox regression. Results: A total of 2044 patients were included in analysis. At diagnosis, median age was 58 years (IQR: 43-69), female-to-male ratio was 2.8:1 and majority of patients were in NYHA FC III-IV (82%). Median diagnostic interval was 1.2 years (IQR: 0.6-2.7). Age, CHD-PAH, obstructive sleep apnoea and peripheral vascular disease were independently associated with diagnostic interval of ≥1 year. No improvement in diagnostic interval was seen during the study period. Longer diagnostic interval was associated with decreased 5-year survival. Conclusion: PAH patients experience significant diagnostic interval, which has not improved despite increased community awareness. Age, cardiovascular and respiratory comorbidities are significantly associated with longer time to diagnosis. Mortality rates appear higher in patients who experience longer diagnostic interval.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherWiley-Blackwell
dc.publisher.placeAustralia
dc.relation.ispartofjournalRespirology
dc.subject.fieldofresearchClinical Sciences
dc.subject.fieldofresearchMedical and Health Sciences
dc.subject.fieldofresearchcode1103
dc.subject.fieldofresearchcode11
dc.subject.keywordscohort studies
dc.subject.keywordsdelayed diagnosis
dc.subject.keywordsmortality
dc.subject.keywordspulmonary hypertension
dc.subject.keywordssurvival analysis
dc.titleDiagnostic delay in pulmonary arterial hypertension: Insights from the Australian and New Zealand pulmonary hypertension registry
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationKhou, V; Anderson, JJ; Strange, G; Corrigan, C; Collins, N; Celermajer, DS; Dwyer, N; Feenstra, J; Horrigan, M; Keating, D; Kotlyar, E; Lavender, M; McWilliams, TJ; Steele, P; Weintraub, R; Whitford, H; Whyte, K; Williams, TJ; Wrobel, JP; Keogh, A; Lau, EM, Diagnostic delay in pulmonary arterial hypertension: Insights from the Australian and New Zealand pulmonary hypertension registry., Respirology, 2020
dcterms.dateAccepted2020-01-06
dc.date.updated2020-02-10T01:36:22Z
gro.description.notepublicThis publication has been entered into Griffith Research Online as an Advanced Online Version.
gro.hasfulltextNo Full Text
gro.griffith.authorAnderson, James


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