ABSTRACT
BACKGROUND: Atrial fibrillation (AF) represents a prevalent cardiac arrhythmia associated with increased risks of stroke and bleeding events, necessitating comprehensive risk assessment and management strategies. OBJECTIVE: This retrospective cohort research aimed to longitudinally analyze risk factors associated with stroke and bleeding incidents in patients diagnosed with AF, focusing on identifying predictive factors and their impact on patient outcomes. METHODS: The research enrolled 480 AF patients from a tertiary care center over an 18-month period (2021-2022). Baseline demographic, clinical, and medication data were collected from electronic health records. Patients were monitored for occurrences of stroke and bleeding events during follow-up. Cox proportional hazards models and Kaplan-Meier estimates were utilized to assess risk factor associations and cumulative event incidences, respectively. RESULTS: A cohort of 480 AF patients, with a mean age of 65.4 years, was observed over 18 months. Stroke patients tended to be older (72.1 years), and bleeders slightly younger (68.8 years). Cox models revealed higher stroke risk in >70-year-olds (hazard ratio (HR): 1.85, 95% confidence interval (95% CI): 1.21-2.78, p < 0.001) and with prior stroke history (HR: 2.13, 95% CI: 1.45-3.12, p < 0.001). Prior stroke linked to bleeding risk (HR: 1.88, 95% CI: 1.26-2.81, p = 0.003). At six months, stroke incidence was 5.2%, bleeding 3.8%; at 18 months, 12.5% experienced strokes, 9.3% bleeding. These findings underscore age and prior stroke as vital predictors of adverse outcomes in AF patients. CONCLUSION: This research reaffirms age and prior stroke as pivotal risk factors for adverse outcomes in AF patients. The findings emphasize the necessity for tailored risk stratification and interventions to mitigate stroke and bleeding risks, thereby enhancing patient care and prognosis in AF management.
ABSTRACT
BACKGROUND: Hospital readmissions among chronic kidney disease (CKD) patients pose substantial challenges in healthcare, impacting both patients and healthcare systems. Understanding the patterns and determinants of CKD-related readmissions is crucial for devising effective interventions. OBJECTIVE: This research aimed to investigate the factors contributing to hospital readmissions among CKD patients, identify the primary reasons for readmissions, and explore potential interventions to mitigate readmission risks. METHODS: A retrospective analysis was conducted among a cohort of 300 CKD patients over an 18-month period at a tertiary care unit specializing in nephrology services. Data on demographics, CKD stages, comorbidities, reasons for readmissions, and lengths of hospital stays were analyzed. Logistic regression models were employed to identify predictors of readmissions. RESULTS: Advancing CKD stages were associated with increased readmission rates, with higher rates observed in older patients. Cardiovascular complications and acute kidney injury were prominent reasons for readmissions. Age, comorbid conditions, and previous hospitalizations emerged as significant predictors of readmissions. Lengths of hospital stays during readmissions were also correlated with CKD stages. CONCLUSION: The research underscores the complex interplay of demographic and clinical factors contributing to hospital readmissions among CKD patients. Tailored interventions addressing disease severity, comorbidities, and patient-specific characteristics are pivotal in reducing readmission risks and enhancing care outcomes for this population.
