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Increasing atrial fibrillation prevalence in acute ischemic stroke and TIA
- Source :
- Neurology. 87:2034-2042
- Publication Year :
- 2016
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2016.
-
Abstract
- To evaluate trends in atrial fibrillation (AF) prevalence in acute ischemic stroke (AIS) and TIA in the United States.We used the Nationwide Inpatient Sample to retrospectively compute weighted prevalence of AF in AIS (n = 4,355,140) and TIA (n = 1,816,459) patients admitted to US hospitals from 2004 to 2013. Multivariate-adjusted models were used to evaluate the association of AF with clinical factors, mortality, length of stay, and cost.From 2004 to 2013, AF prevalence increased by 22% in AIS (20%-24%) and by 38% in TIA (12%-17%). AF prevalence varied by age (AIS: 6% in 50-59 vs 37% in ≥80 years; TIA: 4% in 50-59 vs 24% in ≥80 years), sex (AIS: male 19% vs female 25%; TIA: male 15% vs female 14%), race (AIS: white 26% vs black 12%), and region (AIS: Northeast 25% vs South 20%). Advancing age, female sex, white race, high income, and large hospital size were associated with increased odds of AF in AIS. AF in AIS was a risk factor for in-hospital death (odds ratio 1.93, 95% confidence interval 1.89-1.98) but mortality in AIS with AF decreased from 11.6% to 8.3% (p0.001). Compared to no AF, AF was associated with increased cost of $2,310 and length of stay 1.1 days in AIS.AF prevalence in AIS and TIA has continued to increase. Disparity in AF prevalence in AIS and TIA exists by patient and hospital factors. AF is associated with increased mortality in AIS. Innovative AIS preventive strategies are needed in patients with AF, especially in the elderly.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
030204 cardiovascular system & hematology
Article
Brain Ischemia
White race
Young Adult
03 medical and health sciences
Sex Factors
0302 clinical medicine
Internal medicine
Atrial Fibrillation
Prevalence
Humans
Medicine
In patient
Longitudinal Studies
Risk factor
Acute ischemic stroke
business.industry
Age Factors
Female sex
Atrial fibrillation
Odds ratio
medicine.disease
United States
Confidence interval
Hospitalization
Stroke
Logistic Models
Ischemic Attack, Transient
Female
Neurology (clinical)
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 1526632X and 00283878
- Volume :
- 87
- Database :
- OpenAIRE
- Journal :
- Neurology
- Accession number :
- edsair.doi.dedup.....d4d32330ed1f2e940901109e143abf66