Author + information
Background: Failure to prevent stroke in patients with atrial fibrillation (AF) is an important patient safety concern, especially in those ≥75 years. Our aim was to determine anticoagulation rates and outcomes in advanced elderly (≥75 years) outpatients with AF within a multicenter clinic network.
Methods: We conducted a multicenter, retrospective cohort analysis of 2,060 outpatients ≥75 years with AF identified by our electronic health record between March 2013 and March 2014.
Results: Advanced elderly outpatients with AF had a mean age of 83 years compared with 62 years for those who were not advanced elderly. Anticoagulation was prescribed to 55% of outpatients ≥75 years with AF compared with 42% of outpatients <75 years with AF (p<0.001) (Figure). Outpatients ≥75 years with AF had greater 90-day all-cause mortality (2.2% vs. 0.5%, p<0.001), frequency of stroke (2.6% vs. 0.9%, p<0.001) and frequency of bleeding (4.6% vs. 3.1%, p<0.01). Hospitalization within 30 days predicted increased 90-day mortality (adjusted odds ratio [OR], 5.37; 95% confidence interval [CI], 2.22-12.98), stroke at 90 days (adjusted OR, 2.58; 95% CI 1.02-6.49) and bleeding at 90 days (adjusted OR, 3.11; 95% CI 1.52-6.34) in outpatients ≥75 years.
Conclusions: Recent hospitalization predicted increased 90-day mortality, stroke, and bleeding in outpatients ≥75 years with AF. Hospitalization represents a critical opportunity to provide integrated care that maximizes preventive measures to reduce death, stroke, and bleeding.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Vascular Medicine: Emerging Concepts in Clinical Vascular Diseases
Abstract Category: 40. Vascular Medicine: Non Coronary Arterial Disease
Presentation Number: 1254-356
- 2017 American College of Cardiology Foundation