Prevalence and outcomes of atrial fibrillation in older people living in care homes in Wales: a routine data linkage study 2003–2018.
Objective To determine atrial fibrillation (AF) prevalence and temporal trends, and examine associations between AF and risk of adverse health outcomes in older care home residents. Methods Retrospective cohort study using anonymised linked data from the Secure Anonymised Information Linkage Databan...
| Publicado en: | Age & Ageing Vol. 51; no. 12; pp. 1 - 11 |
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| Autores principales: | , , , , , , , , , , , , |
| Formato: | Artículo |
| Publicado: |
Oxford University Press / USA
Dec2022
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=161116504&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 161116504 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Dec2022 vid: 51 iid: 12 pid: 622 pub: Oxford University Press / USA artinfo: ui: 161116504 10.1093/ageing/afac252 ppf: 1 ppct: 10 formats: tig: atl: Prevalence and outcomes of atrial fibrillation in older people living in care homes in Wales: a routine data linkage study 2003–2018. aug: au: Ritchie, Leona A Harrison, Stephanie L Penson, Peter E Akbari, Ashley Torabi, Fatemeh Hollinghurst, Joe Harris, Daniel Oke, Oluwakayode B Akpan, Asangaedem Halcox, Julian P Rodgers, Sarah E Lip, Gregory Y H Lane, Deirdre A affil: Liverpool Centre for Cardiovascular Science, University of Liverpool , Liverpool L7 8TX, UK Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool , Liverpool L7 8TX, UK School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University , Liverpool L3 3AF, UK Population Data Science, Health Data Research UK, Swansea University Medical School, Swansea University , Swansea, Wales SA2 8PP, UK Population Data Science, Administrative Data Research Wales, Swansea University Medical School, Swansea University , Swansea, Wales SA2 8PP, UK Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences , University of Liverpool , Liverpool L7 8TX, UK Liverpool University Hospitals NHS Foundation Trust , Liverpool L9 7AL, UK Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool , Liverpool L69 3GF, UK Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University , Aalborg DK-9220, Denmark Liverpool Heart and Chest Hospital , Liverpool L14 3PE, UK su: Wales Retrospective studies Psychosocial factors Hospital care Disease risk factors Old age Nursing home residents Major adverse cardiovascular events Ischemic stroke Atrial fibrillation Health outcome assessment Regression analysis Descriptive statistics Disease prevalence Longitudinal method Proportional hazards models sug: subj: Retrospective studies Psychosocial factors Hospital care Disease risk factors Old age Wales Nursing home residents Major adverse cardiovascular events Ischemic stroke Atrial fibrillation Health outcome assessment Regression analysis Descriptive statistics Disease prevalence Longitudinal method Proportional hazards models keyword: care homes health outcomes older people prevalence stroke care homes health outcomes older people prevalence stroke ab: Objective To determine atrial fibrillation (AF) prevalence and temporal trends, and examine associations between AF and risk of adverse health outcomes in older care home residents. Methods Retrospective cohort study using anonymised linked data from the Secure Anonymised Information Linkage Databank on CARE home residents in Wales with AF (SAIL CARE-AF) between 2003 and 2018. Fine-Gray competing risk models were used to estimate the risk of health outcomes with mortality as a competing risk. Cox regression analyses were used to estimate the risk of mortality. Results There were 86,602 older care home residents (median age 86.0 years [interquartile range 80.8–90.6]) who entered a care home between 2003 and 2018. When the pre-care home entry data extraction was standardised , the overall prevalence of AF was 17.4% (95% confidence interval 17.1–17.8) between 2010 and 2018. There was no significant change in the age- and sex-standardised prevalence of AF from 16.8% (15.9–17.9) in 2010 to 17.0% (16.1–18.0) in 2018. Residents with AF had a significantly higher risk of cardiovascular mortality (adjusted hazard ratio [HR] 1.27 [1.17–1.37], P < 0.001), all-cause mortality (adjusted HR 1.14 [1.11–1.17], P < 0.001), ischaemic stroke (adjusted sub-distribution HR 1.55 [1.36–1.76], P < 0.001) and cardiovascular hospitalisation (adjusted sub-distribution HR 1.28 [1.22–1.34], P < 0.001). Conclusions Older care home residents with AF have an increased risk of adverse health outcomes, even when higher mortality rates and other confounders are accounted for. This re-iterates the need for appropriate oral anticoagulant prescription and optimal management of cardiovascular co-morbidities, irrespective of frailty status and predicted life expectancy. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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