It is unclear whether the association between atrial fibrillation (AF) and intra-hospital
mortality in patients aged 75 years and older is causal or not. This study aims (1)
to describe the prevalence and clinical characteristics of AF in ≥75-year-old inpatients
and (2) to study the association between AF and length of stay (LOS) and intra-hospital
mortality. This retrospective cohort study includes consecutive patients aged ≥75
years admitted between January 2017 and December 2019 to a Belgian secondary hospital.
Survival analysis was conducted on the whole dataset and a propensity score-matched
dataset separately. Propensity score matching (PSM) was performed to account for the
individual probability of having AF given a set of covariates. In 9,105 patients,
3,137 (34%) had a diagnosis of AF upon hospital admission. AF prevalence increased
with age strata (from 29% to 38%), and Charlson Co-morbidity Index (from 28% to 57%).
Intra-hospital mortality (20%) was higher in the AF group than in the AF-free group
(25% vs 17%, p <0.001). The median LOS was 11 days and was shorter in those without
AF (10 [4, 17] days) compared with those with AF (11 [5, 19], p <0.001). After PSM,
AF was not associated with increased odds of LOS >10 days (odds ratio 1.08, confidence
interval: 0.98 to 1.20, p = 0.13). The risk of intra-hospital death for patients with
AF remained higher compared with those without AF (log-rank p = 0.0015 and hazard
ratio 1.17; confidence interval: 1.04 to 1.32, p = 0.008). In conclusion, the prevalence
of AF was high (34%) in inpatients aged ≥75 years and increased with age and co-morbidity
burden. After PSM, patients with AF had a 17% higher risk of intra-hospital mortality
than patients without AF.
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Article Info
Publication History
Published online: June 18, 2022
Received in revised form:
April 25,
2022
Received:
March 14,
2022
Identification
Copyright
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