Hospitalized frail elderly patients – atrial fibrillation, anticoagulation and 12 months’ outcomes

Figures & data

Table 1 Baseline clinical and demographic characteristics of patients with AF diagnosis (n = 190) and patients without AF diagnosis (n = 218), reported during the index care episode, unadjusted analysis

Characteristics	Patients with AF diagnosis (n=190)	Patients without AF diagnosis (n=218)	p-value
Age, mean (yrs) (SD)	86.1 (5.1)	85.3 (5.6)	0.10
Gender, male, n (%)	84 (44.2)	94 (43.1)	0.84
Smoker, n (%)	6 (3.3)	12 (5.8)	0.34
Charlson score, mean (SD)	6.8 (1.8)	6.8 (2.0)	0.87
ADL score, mean (SD)	4.4 (2.5)	4.8 (2.5)	0.18
Frailty score, mean (SD)	3.5 (0.83)	3.4 (0.90)	0.14
Residential care,§ n (%)	28 (14.7)	24 (11.0)	0.30
Own living with home help services, n (%)	96 (50.5)	116 (53.2)	0.62
Hypertension, n (%)	154 (81.1)	137 (62.8)	<0.001
Ischemic heart disease, n (%)	62 (32.6)	62 (28.4)	0.39
Chronic heart failure, n (%)	107 (56.3)	57 (26.1)	<0.001
Cerebrovascular disease, n (%)	55 (28.9)	52 (23.9)	0.26
Peripheral arterial disease, n (%)	11 (5.8)	15 (6.9)	0.69
COPD, n (%)	29 (15.3)	48 (22.0)	0.10
Tumor, n (%)	24 (12.6)	43 (19.7)	0.06
Dementia, n (%)	22 (11.6)	25 (11.5)	1.00
Anemia, n (%)	102 (53.7)	110 (50.5)	0.55
Diabetes, n (%)	28 (14.7)	44 (20.2)	0.15
Renal impairment,* n (%)	176 (92.6)	180 (82.6)	0.003
Highest creatinine (µmol/L), mean (SD)	132 (85)	126 (105)	0.64
Lipid lowering therapy, n (%)	39 (20.5)	55 (25.2)	0.29
CHA2DS2-VASc score	4.9 (1.4)	4.4 (1.4)	0.003
Index diagnosis acute heart failure, n (%)	93 (49.5)	38 (17.5)	<0.001
Index diagnosis bacterial infection, n (%)	79 (41.6)	104 (47.7)	0.23
Index diagnosis myocardial infarction, n (%)	10 (5.3)	10 (4.6)	0.82
LOS index, days, mean, n (SD)	10.6 (7.1)	9.8 (6.1)	0.40

Notes:

§ Living in care facilities;

* defined as glomerular filtration rate <90 mL/min/1.73 m².

Abbreviations: AF, atrial fibrillation; LOS, length of stay; ADL, activities of daily living.

Figure 1 Flow chart.

Note: AF diagnosis at index includes paroxysmal, persistent and permanent AF.
Abbreviation: AF, atrial fibrillation.

Table 2 Baseline clinical and demographic characteristics of AF patients on anticoagulation treatment (n = 119) and patients without anticoagulation treatment (n = 71), reported during the index care episode, unadjusted analysis

Characteristics	AF patients with anticoagulation (n = 119)	AF patients without anticoagulation (n = 71)	p-value
Age, mean (yrs) (SD)	84.7 (4.8)	88.4 (4.6)	<0.001
Gender, male, n (%)	60 (50.4)	24 (33.8)	0.03
Charlson score, mean (SD)	6.9 (1.8)	6.6 (1.6)	0.29
ADL score, mean (SD) (4/2)*	4.0 (2.6)	5.2 (2.3)	0.003
Frailty score, mean (SD)	3.4 (0.88)	3.6 (0.75)	0.24
MNA, mean (SD) (3/3)*	10.9 (2.5)	9.8 (2.5)	0.002
Residential care,§ n (%)	11 (9.2)	17 (23.9)	0.01
Own living with home help services, n (%)	57 (47.9)	39 (54.9)	0.37
Hypertension, n (%)	98 (82.4)	56 (78.9)	0.57
Ischemic heart disease, n (%)	36 (30.3)	26 (36.6)	0.42
Chronic heart failure, n (%)	67 (56.3)	40 (56.3)	1.00
Cerebrovascular disease, n (%)	33 (27.7)	22 (31.0)	0.74
Peripheral arterial disease, n (%)	8 (6.7)	3 (4.2)	0.54
COPD, n (%)	22 (18.5)	7 (9.9)	0.14
Tumor, n (%)	13 (10.9)	11 (15.5)	0.37
Dementia, n (%)	10 (8.4)	12 (16.9)	0.10
Anemia, n (%)	59 (49.6)	43 (60.6)	0.18
Diabetes, n (%)	19 (16.0)	9 (12.7)	0.67
CHA2DS2-VASc score	4.9 (1.5)	4.8 (1.3)	0.87
Index diagnosis acute heart failure, n (%) (1/1)*	64 (54.2)	29 (41.4)	0.10
Index diagnosis bacterial infection, n (%)	47 (39.5)	32 (45.1)	0.54
LOS index, days, mean, n (SD)	10.8 (7.6)	10.3 (6.4)	0.92

Notes:

* Denotes number of patients with missing information in the two groups, respectively;

§ living in care facilities.

Abbreviations: AF, atrial fibrillation; LOS, length of stay; ADL, activities of daily living; MNA, Mini Nutritional Assessment.

Figure 2 Distribution of CHA2DS2-VASc score in patients with atrial fibrillation.

Note: The distribution of CHA2DS2-VASc score in patients receiving anticoagulation (blue) and patients not receiving anticoagulation (green).
Abbreviation: AC, anticoagulation.

Table 3 The 12 months’ outcomes for patients with AF, divided into patients with AF and patients without AF (unadjusted, univariate analysis)

Outcomes	Patients with atrial fibrillation
	AC (n = 119)	Non-AC (n = 71)	p-value
Mortality, n (%)	52 (43.7)#	33 (46.5)#	0.61
Rehospitalization, n (%)	89 (74.8)	52 (73.2)	0.87
No of hospital days, mean (SD)	28.0 (22.8)	28.2 (21.5)	0.94
Falls, n (%)	29 (24.4)	11 (15.5)	0.20
Fractures, n (%)	13 (10.9)	8 (11.3)	1.00
Ischemic stroke/TIA, n (%)	6 (5.0)	8 (11.3)	0.15
Ischemic stroke, n (%)	3 (2.9)#	7 (13.8)#	0.02
Bleeding, n (%)	7 (7.1)#	13 (23.4)#	0.005
Ischemic stroke/bleeding, n (%)	10 (9.9)#	19 (34.2)#	<0.001

Notes:

For outcomes with figures marked

# the p-values were derived from Kaplan–Meier estimates, tested by log rank test, on the basis of known dates of events. For the other outcomes, the p-values were derived from analysis with Student’s t-test or Fisher’s exact test. The outcome ischemic stroke/TIA includes three TIAs in the AC group and one in the non-AC group. The outcome bleeding includes one cerebral hemorrhage in the AC group and one in the non-AC group.

Abbreviations: AF, atrial fibrillation; AC, anticoagulation; TIA, transient ischemic attack.