Clinical characteristics and outcomes of patients with atrial fibrillation and repeat emergency department visits / 解放军医学杂志

ABSTRACT

Objective To explore the clinical characteristics and outcomes of patients with atrial fibrillation (AF) and repeated emergency department (ED) visits.Methods Patients with AF were examined and analyzed retrospectively.Data were collected from consecutive patients from resuscitation room in the Department of Emergency of a large-scale general teaching hospital,from January 1,2011 to December 31,2015.The patients were verified by electrocardiographic examination and/or monitoring.The main outcomes were length of resuscitation room stay and outcome scales (defined as death,transfer to intensive units,to ordinary wards,or direct discharge).Results 908 patients were enrolled in the study with a mean age of 70.3 ± 12.8 years,and 494(54.4％) were female.There were 262(28.9％) cases visited ED for more than one time,and 646(71.1％) visited ED without repetition.Compared with the patients without repeated visit,patients with repeated visits were older (73.0 ± 9.8 years versus 69.2 ± 13.6 years,t=4.705,P＜0.001),and had a larger proportion of patients with CHADS2-VASc score greater or equals to 2(70.6％ versus 60.2％,x2 =8.660,P=0.003),whereas those patients had a shorter stay in the resuscitation room (13.6 ± 27.1h versus 27.0 ± 89.7h,t=3.370,P=0.001),and a higher percentage of directly discharge (73.3％ versus 61.9％,x2=10.607,P=0.001).In multiple logistic regression analysis,a higher CHADS2-VASc score and a lower quartile of the resuscitation room stay were independently predictive factors of repeated ED visits.Conclusion Patients with AF and repeated ED visits would have relatively complex condition and more comorbidities.High CHADS2-VASc score and short ED stay are independently predictive factors for repeated ED visits.