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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 Datab...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9721338/ https://www.ncbi.nlm.nih.gov/pubmed/36469091 http://dx.doi.org/10.1093/ageing/afac252 |
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author | 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 |
author_facet | 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 |
author_sort | Ritchie, Leona A |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-9721338 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-97213382022-12-06 Prevalence and outcomes of atrial fibrillation in older people living in care homes in Wales: a routine data linkage study 2003–2018 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 Age Ageing Research Paper 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. Oxford University Press 2022-12-05 /pmc/articles/PMC9721338/ /pubmed/36469091 http://dx.doi.org/10.1093/ageing/afac252 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the British Geriatrics Society. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Paper 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 Prevalence and outcomes of atrial fibrillation in older people living in care homes in Wales: a routine data linkage study 2003–2018 |
title | Prevalence and outcomes of atrial fibrillation in older people living in care homes in Wales: a routine data linkage study 2003–2018 |
title_full | Prevalence and outcomes of atrial fibrillation in older people living in care homes in Wales: a routine data linkage study 2003–2018 |
title_fullStr | Prevalence and outcomes of atrial fibrillation in older people living in care homes in Wales: a routine data linkage study 2003–2018 |
title_full_unstemmed | Prevalence and outcomes of atrial fibrillation in older people living in care homes in Wales: a routine data linkage study 2003–2018 |
title_short | Prevalence and outcomes of atrial fibrillation in older people living in care homes in Wales: a routine data linkage study 2003–2018 |
title_sort | prevalence and outcomes of atrial fibrillation in older people living in care homes in wales: a routine data linkage study 2003–2018 |
topic | Research Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9721338/ https://www.ncbi.nlm.nih.gov/pubmed/36469091 http://dx.doi.org/10.1093/ageing/afac252 |
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