Prevalence and profile of “seasonal frequent flyers” with chronic heart disease: Analysis of 1598 patients and 4588 patient-years follow-up

Jordan Loader, Yih Kai Chan, John A. Hawley, Trine Moholdt, Christine F. McDonald, Pardeep Jhund, Mark C. Petrie, John J. McMurray, Paul A. Scuffham, Jay Ramchand, Louise M. Burrell, Simon Stewart

Research output: Contribution to journalArticle

Abstract

Background: Peaks and troughs in cardiovascular events correlated with seasonal change is well established from an epidemiological perspective but not a clinical one. Methods: Retrospective analysis of the recruitment, baseline characteristics and outcomes during minimum 12-month exposure to all four seasons in 1598 disease-management trial patients hospitalised with chronic heart disease. Seasonality was prospectively defined as ≥4 hospitalisations (all-cause) AND >45% of related bed-days occurring in any one season during median 988 (IQR 653, 1394) days follow-up. Results: Patients (39% female) were aged 70 ± 12 years and had a combination of coronary artery disease (58%), heart failure (54%), atrial fibrillation (50%) and multimorbidity. Overall, 29.9% of patients displayed a pattern of seasonality. Independent correlates of seasonality were female gender (adjusted OR 1.27, 95% CI 1.01–1.61; p = 0.042), mild cognitive impairment (adjusted OR 1.51, 95% CI 1.16–1.97; p = 0.002), greater multimorbidity (OR 1.20, 95% CI 1.15–1.26 per Charlson Comorbidity Index Score; p < 0.001), higher systolic (OR 1.01, 95%CI 1.00–1.01 per 1 mmHg; p = 0.002) and lower diastolic (OR 0.99, 95% CI 0.98–1.00 per 1 mmHg; p = 0.002) blood pressure. These patients were more than two-fold more likely to die (adjusted HR 2.16, 95% CI 1.60–2.90; p < 0.001) with the highest and lowest number of deaths occurring during spring (31.7%) and summer (19.9%), respectively. Conclusions: Despite high quality care and regardless of their diagnosis, we identified a significant proportion of “seasonal frequent flyers” with concurrent poor survival in this real-world cohort of patients with chronic heart disease.

Original languageEnglish
Pages (from-to)126-132
Number of pages7
JournalInternational Journal of Cardiology
Volume279
DOIs
Publication statusPublished - 15 Mar 2019
Externally publishedYes

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Keywords

  • Atrial fibrillation
  • Cardiovascular disease
  • Cardiovascular seasonality
  • Coronary artery disease
  • Heart failure

Cite this

Loader, J., Chan, Y. K., Hawley, J. A., Moholdt, T., McDonald, C. F., Jhund, P., Petrie, M. C., McMurray, J. J., Scuffham, P. A., Ramchand, J., Burrell, L. M., & Stewart, S. (2019). Prevalence and profile of “seasonal frequent flyers” with chronic heart disease: Analysis of 1598 patients and 4588 patient-years follow-up. International Journal of Cardiology, 279, 126-132. https://doi.org/10.1016/j.ijcard.2018.12.060