Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Quality Measures & Complications
D-PO05 - Poster Session V (ID 39)
Poster
D-PO05-134 - Performance Measure Achievement In Patients Hospitalized With Atrial Fibrillation: Results From The Get With The Guidelines-AFIB (GWTG-AFIB) Registry (ID 1274)
Abstract
Background: The GWTG-AFIB registry has utilized performance measures to facilitate optimal care of patients hospitalized with atrial fibrillation (AF).
Objective: We sought to evaluate overall and site-level variation in achievement of these measures in clinical practice.
Methods: Using the GWTG-AFIB registry cohort, we included patients with AF admitted between 01/2013 through 06/2019. We excluded patients from sites treating <25 patients. Achievement of 6 performance measures (Figure) was assessed and used to calculate 1) defect free scores, defined as 100% adherence to all eligible measures, and 2) composite opportunity scores, defined as the proportion of eligible measures achieved. We used multivariable logistic regression to determine associations between patient-level variables with top performing sites by defect free score quartile.
Results: Among 80,951 patients (age 70±13, CHA2DS2-VASc 3.6±1.8) at 132 sites, site-level defect-free and composite opportunity scores of performance measures varied substantially (Figure). Oral anticoagulation (OAC) was prescribed in 53,504 patients, 95% of those eligible. In multivariable models, age, per 10 year increase beyond 75 years (defect free OR 0.74, 95% CI 0.59-0.92, p 0.008), peripheral vascular disease (defect free OR 0.78, 95% CI 0.64-0.94, p 0.01), and diabetes (defect free OR 0.86, 95% CI 0.78-0.95, p 0.005) were negatively associated with top quartile performance.
Conclusion: At sites participating in the GWTG-AFIB registry, despite relatively high OAC prescription, overall achievement of AF performance measures was variable. Meaningful opportunities exist to improve AF care beyond OAC prescription.
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Objective: We sought to evaluate overall and site-level variation in achievement of these measures in clinical practice.
Methods: Using the GWTG-AFIB registry cohort, we included patients with AF admitted between 01/2013 through 06/2019. We excluded patients from sites treating <25 patients. Achievement of 6 performance measures (Figure) was assessed and used to calculate 1) defect free scores, defined as 100% adherence to all eligible measures, and 2) composite opportunity scores, defined as the proportion of eligible measures achieved. We used multivariable logistic regression to determine associations between patient-level variables with top performing sites by defect free score quartile.
Results: Among 80,951 patients (age 70±13, CHA2DS2-VASc 3.6±1.8) at 132 sites, site-level defect-free and composite opportunity scores of performance measures varied substantially (Figure). Oral anticoagulation (OAC) was prescribed in 53,504 patients, 95% of those eligible. In multivariable models, age, per 10 year increase beyond 75 years (defect free OR 0.74, 95% CI 0.59-0.92, p 0.008), peripheral vascular disease (defect free OR 0.78, 95% CI 0.64-0.94, p 0.01), and diabetes (defect free OR 0.86, 95% CI 0.78-0.95, p 0.005) were negatively associated with top quartile performance.
Conclusion: At sites participating in the GWTG-AFIB registry, despite relatively high OAC prescription, overall achievement of AF performance measures was variable. Meaningful opportunities exist to improve AF care beyond OAC prescription.
