ISSN 1671-5411 CN 11-5329/R
Volume 18 Issue 2
Mar.  2021
Turn off MathJax
Article Contents
Please cite this article as: Voruganti D, Shantha G, Dugyala S, Bolton A, Mohsen A, Devabhaktuni S, Paydak H, Mehta JL. Gender differences, outcomes and trends among nonagenarian with atrial fibrillation: insight from National Inpatient Sample database. J Geriatr Cardiol 2021; 18(2): 114−122. DOI: 10.11909/j.issn.1671-5411.2021.02.007
Citation: Please cite this article as: Voruganti D, Shantha G, Dugyala S, Bolton A, Mohsen A, Devabhaktuni S, Paydak H, Mehta JL. Gender differences, outcomes and trends among nonagenarian with atrial fibrillation: insight from National Inpatient Sample database. J Geriatr Cardiol 2021; 18(2): 114−122. DOI: 10.11909/j.issn.1671-5411.2021.02.007

Gender differences, outcomes and trends among nonagenarian with atrial fibrillation: insight from National Inpatient Sample database

doi: 10.11909/j.issn.1671-5411.2021.02.007
More Information
  •  BACKGROUND Nonagenarians (NG), individuals aged ≥ 90 years, constitute an increasing proportion of hospitalizations presenting with atrial fibrillation (AF). However, not much is known about demographics, clinical outcomes, and trends of hospitalizations. Therefore, we analyzed data about hospitalizations and clinical outcomes among NGs with AF over ten years from 2005 to 2014 using a publically available database, the National Inpatient Sample. METHODS All hospitalizations and major outcomes of subjects ≥ 90 years with a primary diagnosis of AF (ICD-9-CM code 427.31) over a ten-year period were assessed in this study by multivariate logistic regression analysis. RESULTS There were more females than males (176,268 females, 51,384 males) in this analysis. The number of hospitalizations for AF among NG increased by 50% (17,295 in 2005 to 25,830 in 2014). Males were more likely to undergo cardioversion (6.14% of males vs. 5.06% of females, P < 0.0001). Over this period, in-hospital mortality declined from 3.21% in 2005 to 2.38% in 2014 (P = 0.0041), with higher in-hospital mortality in males (3.23% in males vs. 2.76% in females, P = 0.0138), mean length of hospitalization decreased from 4.53 days to 4.13 days (P < 0.0001), the prevalence of congestive heart failure fell from 0.48% to 0.23% (P = 0.0257), and the use of anticoagulation increased from 6.09% to 14.54% (P < 0.0001). In a multivariate analysis, hospital admission on the weekend, Elixhauser comorbidity index, CHA2DS2VASc score, acute respiratory failure, and the length of hospital stay were associated with a higher risk of in-hospital mortality. CONCLUSIONS From 2005 to 2014, AF-related hospitalizations among NGs increased, more so in in females population, mortality trends improved, rates of anticoagulation increased, and cardioversions increased. Despite the decreasing trend of in-hospital mortality since 2005, the relatively high mortality rate in males warrants further studies.
  • loading
  • [1]
    Chugh SS, Blackshear JL, Shen WK, et al. Epidemiology and natural history of atrial fibrillation: clinical implications. J Am Coll Cardiol 2001; 37: 371−378. doi: 10.1016/S0735-1097(00)01107-4
    [2]
    Voruganti DC, Subash Shantha GP, Deshmukh A, et al. Outcomes of hospitalizations with atrial fibrillation-flutter on a weekday versus weekend: an analysis from a 2014 nationwide inpatient sample. PeerJ 2019; 7: e6211. doi: 10.7717/peerj.6211
    [3]
    Voruganti DC, Shantha G, Dugyala S, et al. Temporal trends and factors associated with increased mortality among atrial fibrillation weekend hospitalizations: an insight from National Inpatient Sample 2005–2014. BMC Res Notes 2019; 12: 398. doi: 10.1186/s13104-019-4440-8
    [4]
    Deshmukh A, Pant S, Kumar G, et al. Comparison of outcomes of weekend versus weekday admissions for atrial fibrillation. Am J Cardiol 2012; 110: 208−211. doi: 10.1016/j.amjcard.2012.03.011
    [5]
    United States Bureau of Labor Statistics. United States Bureau of Labor Statistics of CPI Inflation Calculator Web site. https://www.bls.gov/data/inflation_calculator.htm (accessed October 20, 2020).
    [6]
    Agency for Health Care Quality and Research. Overview of the National (Nationwide) Inpatient Sample (NIS) Web site. https://www.hcup-us.ahrq.gov/nisoverview.jsp (accessed October 20, 2020).
    [7]
    Formiga F, Ferrer A, Henríquez E, et al. [Low percentage of oral anticoagulation in nonagenarians with atrial fibrillation]. Rev Clin Esp 2006; 206: 410−411. [In Spanish]. doi: 10.1157/13090516
    [8]
    Wutzler A, von Ulmenstein S, Attanasio P, et al. Treatment of nonagenarians with atrial fibrillation: insights from the Berlin Atrial Fibrillation (BAF) Registry. J Am Med Dir Assoc 2015; 16: 969−972. doi: 10.1016/j.jamda.2015.05.012
    [9]
    Ramos Tuarez FJ, Pino JE, Alrifai A, et al. Long-term quality of life in octogenarians and nonagenarians with nonvalvular atrial fibrillation following WATCHMANTM device implantation. Catheter Cardiovasc Interv 2019; 93: 1138−1145. doi: 10.1002/ccd.28020
    [10]
    Martínez-Sellés M, Datino T, Figueiras-Graillet LM, et al. New-onset atrial fibrillation and prognosis in nonagenarians after acute myocardial infarction. Neth Heart J 2013; 21: 499−503. doi: 10.1007/s12471-013-0439-2
    [11]
    Waldron I. Why do women live longer than men? Soc Sci Med 1976; 10: 349−362. doi: 10.1016/0037-7856(76)90090-1
    [12]
    Silman AJ. Why do women live longer and is it worth it? Br Med J (Clin Res Ed) 1987; 294: 1311−1312. doi: 10.1136/bmj.294.6583.1311
    [13]
    Austad SN. Why women live longer than men: sex differences in longevity. Gend Med 2006; 3: 79−92. doi: 10.1016/S1550-8579(06)80198-1
    [14]
    Hazzard WR. Why do women live longer than men? Biologic differences that influence longevity. Postgrad Med 1989; 85: 271−283. doi: 10.1080/00325481.1989.11700672
    [15]
    United States Census Bureau. 2010 United States Census Special Reports Web site. https://www.census.gov/prod/cen2010/reports/c2010sr-03.pdf (accessed October 20, 2020).
    [16]
    Weeda ER, Hodgdon N, Do T, et al. Association between weekend admission for atrial fibrillation or flutter and in-hospital mortality, procedure utilization, length-of-stay and treatment costs. Int J Cardiol 2016; 202: 427−429. doi: 10.1016/j.ijcard.2015.09.053
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(2)  / Tables(4)

    Article Metrics

    Article views (747) PDF downloads(31) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return