Journal article 654 views 89 downloads
Prevalence and outcomes of atrial fibrillation in older people living in care homes in Wales: a routine data linkage study 2003–2018
,
Stephanie L Harrison ,
Peter E Penson ,
Ashley Akbari ,
Fatemeh Torabi ,
Joseph Hollinghurst,
Daniel Harris,
Oluwakayode B Oke,
Asangaedem Akpan,
Julian Halcox ,
Sarah E Rodgers,
Gregory Y H Lip,
Deirdre A Lane
Age and Ageing, Volume: 51, Issue: 12
Swansea University Authors:
Ashley Akbari , Fatemeh Torabi , Joseph Hollinghurst, Daniel Harris, Julian Halcox
-
PDF | Version of Record
© The Author(s) 2022. This is an Open Access ar ticle distributed under the terms of the Creative Commons Attribution License
Download (608.19KB)
DOI (Published version): 10.1093/ageing/afac252
Abstract
ObjectiveTo determine atrial fibrillation (AF) prevalence and temporal trends, and examine associations between AF and risk of adverse health outcomes in older care home residents.MethodsRetrospective cohort study using anonymised linked data from the Secure Anonymised Information Linkage Databank o...
| Published in: | Age and Ageing |
|---|---|
| ISSN: | 0002-0729 1468-2834 |
| Published: |
Oxford University Press (OUP)
2022
|
| Online Access: |
Check full text
|
| URI: | https://cronfa.swan.ac.uk/Record/cronfa62133 |
| Abstract: |
ObjectiveTo determine atrial fibrillation (AF) prevalence and temporal trends, and examine associations between AF and risk of adverse health outcomes in older care home residents.MethodsRetrospective 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.ResultsThere 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).ConclusionsOlder 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. |
|---|---|
| Keywords: |
Atrial fibrillation, stroke, care homes, prevalence, health outcomes, older people |
| College: |
Faculty of Medicine, Health and Life Sciences |
| Funders: |
This work was supported by
Health Data Research UK [HDR-9006], which receives
its funding from the UK Medical Research Council; Engineering and Physical Sciences Research Council; Economic
and Social Research Council; Department of Health and
Social Care (England); Chief Scientist Office of the Scottish
Government Health and Social Care Directorates; Health
and Social Care Research and Development Division
(Welsh Government); Public Health Agency (Northern
Ireland); British Heart Foundation (BHF) and the Wellcome
Trust and Administrative Data Research UK which is
funded by the Economic and Social Research Council
[grant ES/S007393/1]. SER is part-funded by the National
Institute for Health Research (NIHR) Applied Research
Collaboration North West Coast (ARC NWC). The views
expressed are those of the authors and not necessarily
those of the NIHR or the Department of Health and
Social Care. |
| Issue: |
12 |