Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Quality Measures & Complications D-PO04 - Poster Session IV (ID 15) Poster

D-PO04-202 - Admissions For Atrial Fibrillation In The Elderly Population: Evaluation Of Demographic Predictors Of Mortality (ID 1234)

Disclosure
 M.M. Refaat: Nothing relevant to disclose.

Abstract

Background: Atrial fibrillation (AF) is the most common arrhythmia affecting elderly patients and causes significant morbidity and mortality.
Objective: To delineate regional and hospital-based variables associated with mortality in a population of elderly patients admitted with a diagnosis of AF in the United States.
Methods: We used the National (Nationwide) Inpatient Sample of elderly patients (aged more than 70 years) & admitted with AF between 2005 and 2014. We studied variables such as race, gender, hospital location, hospital teaching status, hospital bed size and hospital region to elucidate the association with mortality. We did a multivariate regression analysis to identify independent predictors of mortality.
Results: A total of 2,163,343 elderly patients were admitted between 2005 and 2014 with a diagnosis of AF. 30,391 (1.4%) of these patients died during their hospitalization. There was an association between gender and mortality (1.37% of women died,1.48% of men died, p = 0.004). Patients who were of Caucasian ancestry had a lower mortality (1.38%) than other races (p-value < 0.0001). There was no correlation between hospital bed size or hospital teaching status and mortality. However, hospital location (1.39% mortality in urban,1.51% mortality in rural areas) and hospital state region (1.24% mortality [least] in the Midwest and 1.58% mortality [highest] in the Northeast), were associated with mortality, with p-values of 0.022 and < 0.0001 respectively. A multivariate regression analysis showed a weekend effect on mortality in AF (OR= 1.14, 95% CI 1.07-1.22, p < 0.001) as well as regional variation [Northeast as reference; Midwest OR = 0.81, 95% CI 0.74-0.89, p< 0.001; South OR = 0.91, 95% CI 0.84-0.99, p=0.023; West OR = 0.81, 95% CI 0.73-0.90, p< 0.001]. Alcohol abuse (OR= 1.33, 95% CI 1.08- 1.66, p = 0.009) and drug abuse ( OR= 2.22, 95% CI 1.39-3.57, p= 0.001) are independent predictors of mortality. The risk adjusted mortality trend showed that mortality has not changed for elderly patients between 2005-2014 (varied from 0.75% and 0.95%) despite the advancement in management (P-trend=0.16).
Conclusion: This study on the mortality of elderly patients with AF reflects gaps in the uniformity of nationwide medical care that the United States aims to achieve.
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