Inverclyde Royal Hospital, Greenock
Stefan Hindmarsh is a resident doctor working for the NHS in UK. Graduated from Aberdeen University medical school in 2016. President of the Medical Society as well as playing Secretary of the University Golf Team.
During the final year of training, spent time in a New Jersey ER/Trauma Centre where I got experience in pericardiocentesis as well as acute management of cardiac presentations.
While working as a Cardiology resident, he became adept at ECGs interpretation and Echocardiography. His interest is management of acute heart failure, identification and validation of novel factors predicting and/or affecting heart failure adverse outcomes
In this retrospective study, 96 patients admitted with Heart failure(HF) from the most deprived and least deprived tertile of Scottish Index of Multiple Deprivation (SIMD) (1 – 3 – most deprived and 7 - 9 – least deprived).
Between the two groups, no statistical difference exists between age, gender, haemoglobin or creatinine level; nor was there any difference in past medical history or cigarette use. Patients from the lower tertile has higher incidence of alcohol excess (16% vs 3%, p = 0.043) while higher incidence of AF for the higher tertile (55% vs 33%, p = 0.004). Prescription of diuretics, Beta-Blocker, ACE-I or ARB were not statistically different. Patients from higher tertile is more likely to receive aldosterone antagonist (37% vs 17%, p = 0.031) and combined Beta-blocker and ACE-i/ARB treatment (42% vs 21%, p = 0.025).
6-months follow-up demonstrates composite endpoint of heart failure readmission and mortality was statistically higher among patients of lower socioeconomic tertile (p = 0.042). Stepwise multiple regression analysis also confirmed socioeconomic deprivation as an independent predictor for more adverse clinical outcome for heart failure (p = 0.003, R2 = 22%).
Summary: Despite the establishment of universal healthcare, patients from the lower socioeconomic group are less likely to received prognostically beneficial medication and are more likely to be experience readmission for heart failure or death