The impact of diabetes on productivity in India.
Aim: Pulmonary vein isolation for symptomatic atrial fibrillation (AF) using cryoablation is a well-established treatment in the Midland region of New Zealand since November 2012. The incidence of AF increases with age; we set out to determine how successful this therapy is with older patients. In this retrospective study, we analysed 1-year success of cryoablation for AF in patients !65 years and compared this group with patients <65y. Method: In the period from April 2013 until February 2016, 215 patients presenting with symptomatic paroxysmal (PAF) or persistent AF (PeAF) who underwent cryoablation (2 nd generation balloon) were included in this retrospective study. Results: For the !65y group (mean 68.7 + /-3.2, range 65-79y) a total of 66 patients with PAF (n = 33) or PeAF (n = 3) were included. In comparison 134 PAF and 15 PeAF patients had cryoablation aged <65y. At !12 months for those !65y, 41/66 patients (62%) were free of AF (off drugs) with another 9/66 (14%) free of AF on anti-arrhythmic therapy. At !12 months for <65y (mean 53.4+/-8.4, range 22-64y) 97/149 (65%) had no AF (off drugs) with 12/149 (8%) on medication. Complications and mortality did not differ between the two groups. Conclusion: Pulmonary vein isolation for AF using cryoablation appears equally effective for patients over the age of 65 years as for younger patients. Success rate at 1 year for !65y is 76% (+/-drugs) compared to 73% for <65y.
<b>OBJECTIVE</b> Diabetes increases the risk of premature mortality and considerably impacts on work productivity. We sought to examine the impact of diabetes in India, in terms of excess premature mortality, years of life lost (YLL), productivity-adjusted life years (PALYs) lost and its associated economic impact. <p><b>RESEARCH DESIGN AND METHODS</b> A lifetable model was constructed to examine the productivity of the Indian working-age population currently aged 20–59 years with diabetes, until death or retirement age (60 years). The same cohort was re-simulated, hypothetically assuming that they did not have diabetes. The total difference between the two cohorts, in terms of excess deaths, YLL and PALYs lost reflected the impact of diabetes. Data regarding the prevalence of diabetes, mortality, labour force dropouts and productivity loss attributable to diabetes were derived from published sources. </p> <p><b>RESULTS</b> In 2017, an estimated 54.4 million (7.6%) people of working-age in India had diabetes. With simulated follow-up until death or retirement age, diabetes was predicted to cause 8.5 million excess deaths (62.7% of all deaths), 42.7 million YLL (7.4% of total estimated years of life lived) and 89.0 million PALYs lost (23.3% of total estimated PALYs), equating to an estimated INR 176.6 trillion (USD 2.6 trillion; PPP 9.8 trillion) in lost GDP<a>. </a></p> <p><b>CONCLUSIONS </b>Our study demonstrates the impact of diabetes on productivity loss and highlights the importance of health strategies aimed at the prevention of diabetes.</p>
<b>OBJECTIVE</b> Diabetes increases the risk of premature mortality and considerably impacts on work productivity. We sought to examine the impact of diabetes in India, in terms of excess premature mortality, years of life lost (YLL), productivity-adjusted life years (PALYs) lost and its associated economic impact. <p><b>RESEARCH DESIGN AND METHODS</b> A lifetable model was constructed to examine the productivity of the Indian working-age population currently aged 20–59 years with diabetes, until death or retirement age (60 years). The same cohort was re-simulated, hypothetically assuming that they did not have diabetes. The total difference between the two cohorts, in terms of excess deaths, YLL and PALYs lost reflected the impact of diabetes. Data regarding the prevalence of diabetes, mortality, labour force dropouts and productivity loss attributable to diabetes were derived from published sources. </p> <p><b>RESULTS</b> In 2017, an estimated 54.4 million (7.6%) people of working-age in India had diabetes. With simulated follow-up until death or retirement age, diabetes was predicted to cause 8.5 million excess deaths (62.7% of all deaths), 42.7 million YLL (7.4% of total estimated years of life lived) and 89.0 million PALYs lost (23.3% of total estimated PALYs), equating to an estimated INR 176.6 trillion (USD 2.6 trillion; PPP 9.8 trillion) in lost GDP<a>. </a></p> <p><b>CONCLUSIONS </b>Our study demonstrates the impact of diabetes on productivity loss and highlights the importance of health strategies aimed at the prevention of diabetes.</p>
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