Despite Improvements, AF Still Significantly Affects Stroke Outcomes
The prevalence of atrial fibrillation (AF)-associated acute ischemic stroke (AIS) has increased in recent years, especially among white and older patients, according to new findings.
Researchers arrived at this conclusion following a study of 930,010 patients aged 18 years and older who were hospitalized for AIS between 2003 and 2014. Eligible patients were identified using the National Inpatient Sample.
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Factors including crude and propensity score-matched in-hospital morbidity and mortality, cost, length of stay, and discharge dispositions were compared between patients with and without AF.
In this sample, approximately 18.2% had AF. Results showed that the prevalence of AF increased from 16.4% in 2003 to 20.4% in 2014. The greatest increase was observed among white and older patients, the researchers noted.
Among 2 pairs of 125,203 patients with AIS with and without AF, the mortality rate was found to be higher among patients with AF vs those without AF (9.9% vs 6.1%). Ischemic stroke in AF was found to be associated with higher incidences of acute kidney injury, bleeding and infectious complications, and severe disability.
Furthermore, factors including hospital length of stay was significantly longer, and cost of care were shown to be 20% higher in patients with AF vs those without AF.
“The prevalence of AF in AIS patients continued to rise, particularly in white and older patients,” the researchers concluded. “Despite the improvement in AIS-related mortality overall, the differential negative impact of AF on the morbidity, mortality, and cost of AIS was steady over the study’s 12-year period.”
—Christina Vogt
Reference:
Alkhouli M, Alqahtani F, Aljohani S, Alvi M, Holmes DR. Burden of atrial fibrillation-associated ischemic stroke in the United States [Published online May 2018]. J Am Coll Cardiol. doi:10.1016/j.jacep.2018.02.021