Ritchie, Leona A 
ORCID: 0000-0002-0392-1767, Harrison, Stephanie L ORCID: 0000-0002-8846-0946, Penson, Peter E ORCID: 0000-0001-6763-1489, Akbari, Ashley, Torabi, Fatemeh, Hollinghurst, Joe, Harris, Daniel, Oke, Oluwakayode B, Akpan, Asangaedem ORCID: 0000-0002-1764-8669, Halcox, Julian P et al (show 3 more authors)
(2022)
Prevalence and outcomes of atrial fibrillation in older people living in care homes in Wales: a routine data linkage study 2003-2018.
AGE AND AGEING, 51 (12).
afac252-.
Abstract
<h4>Objective</h4>To determine atrial fibrillation (AF) prevalence and temporal trends, and examine associations between AF and risk of adverse health outcomes in older care home residents.<h4>Methods</h4>Retrospective 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.<h4>Results</h4>There 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).<h4>Conclusions</h4>Older 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.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Atrial fibrillation, stroke, care homes, prevalence, health outcomes, older people |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences Faculty of Health and Life Sciences > Institute of Population Health |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 30 Jan 2023 09:27 |
| Last Modified: | 30 Jan 2023 09:27 |
| DOI: | 10.1093/ageing/afac252 |
| Open Access URL: | https://doi.org/10.1093/ageing/afac252 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3167947 |
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