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dc.contributor.authorKalesan, Bindu
dc.contributor.authorKundu, Amartya
dc.contributor.authorVaze, Aditya
dc.contributor.authorPino, Elizabeth
dc.contributor.authorWalkey, Allan J.
dc.contributor.authorVasan, Ramachandran S.
dc.contributor.authorMcManus, David D.
dc.date2022-08-11T08:09:51.000
dc.date.accessioned2022-08-23T16:46:20Z
dc.date.available2022-08-23T16:46:20Z
dc.date.issued2018-11-12
dc.date.submitted2018-12-21
dc.identifier.citation<p>Clin Cardiol. 2018 Nov 12. doi: 10.1002/clc.23111. [Epub ahead of print] <a href="https://doi.org/10.1002/clc.23111">Link to article on publisher's site</a></p>
dc.identifier.issn0160-9289 (Linking)
dc.identifier.doi10.1002/clc.23111
dc.identifier.pmid30421445
dc.identifier.urihttp://hdl.handle.net/20.500.14038/40860
dc.description.abstractBACKGROUND: Patients with atrial fibrillation (AF) are at risk for both thromboembolic and bleeding complications. While the risk for thromboembolism is higher among women with AF than men, the sex-related differences in post-discharge outcomes after hospitalization is not clearly understood. HYPOTHESIS: Compared to men, women hospitalized for AF are at a higher risk of both thromboembolic and bleeding complications. METHODS: We conducted a retrospective cohort study using data from the 2013 to 2014 Nationwide Readmission Database (NRD), to compare outcomes among men and women, > /=50 years of age after hospitalization for AF. The primary patient outcome was all-cause rehospitalization at 90-days after initial hospitalization. Survey-weighted Cox proportional hazard regression models were used to estimate the hazard ratios (HR) and their 95% confidence intervals (CI) for bleeding events at 30, 60, 90, and 270 days after hospitalization. RESULTS: From the 28 million patients in the NRD, we identified 522 521 individuals with an index hospitalization for AF. Compared to men, women hospitalized for AF accounted for 53.3% of the cohort and had higher rates of thrombotic (1.7%, 1.4%) and bleeding complications (1.4%, 1.1%). After adjustment, the 90-day risk among women vs men was significantly greater; all-cause rehospitalization (24.2%, 17.0%; HR = 1.07, 95% CI = 1.05-1.09), rehospitalization related to ischemic stroke (0.6%, 0.3%; HR 1.31, 95% CI = 1.14-1.51), pulmonary embolism (0.4%, 0.2%; HR 1.21, 95% CI = 1.01-1.45), and any thrombotic event (1.3%, 0.7%; HR 1.20, 95% CI = 1.09-1.32). CONCLUSIONS: Hospitalization for AF is common and frequently associated with both in-hospital complications and readmission, which were more commonly observed among women with AF. Further research into epidemiological factors and treatment differences between men and women with AF is warranted.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=30421445&dopt=Abstract">Link to Article in PubMed</a></p>
dc.relation.urlhttps://doi.org/10.1002/clc.23111
dc.subjectatrial fibrillation
dc.subjectoutcomes
dc.subjectreadmission
dc.subjectUMCCTS funding
dc.subjectCardiology
dc.subjectCardiovascular Diseases
dc.subjectClinical Epidemiology
dc.subjectEpidemiology
dc.subjectGender and Sexuality
dc.subjectHealth Services Administration
dc.titleSex-differences in post-discharge outcomes among patients hospitalized for atrial fibrillation
dc.typeJournal Article
dc.source.journaltitleClinical cardiology
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/oapubs/3665
dc.identifier.contextkey13525557
html.description.abstract<p>BACKGROUND: Patients with atrial fibrillation (AF) are at risk for both thromboembolic and bleeding complications. While the risk for thromboembolism is higher among women with AF than men, the sex-related differences in post-discharge outcomes after hospitalization is not clearly understood.</p> <p>HYPOTHESIS: Compared to men, women hospitalized for AF are at a higher risk of both thromboembolic and bleeding complications.</p> <p>METHODS: We conducted a retrospective cohort study using data from the 2013 to 2014 Nationwide Readmission Database (NRD), to compare outcomes among men and women, > /=50 years of age after hospitalization for AF. The primary patient outcome was all-cause rehospitalization at 90-days after initial hospitalization. Survey-weighted Cox proportional hazard regression models were used to estimate the hazard ratios (HR) and their 95% confidence intervals (CI) for bleeding events at 30, 60, 90, and 270 days after hospitalization.</p> <p>RESULTS: From the 28 million patients in the NRD, we identified 522 521 individuals with an index hospitalization for AF. Compared to men, women hospitalized for AF accounted for 53.3% of the cohort and had higher rates of thrombotic (1.7%, 1.4%) and bleeding complications (1.4%, 1.1%). After adjustment, the 90-day risk among women vs men was significantly greater; all-cause rehospitalization (24.2%, 17.0%; HR = 1.07, 95% CI = 1.05-1.09), rehospitalization related to ischemic stroke (0.6%, 0.3%; HR 1.31, 95% CI = 1.14-1.51), pulmonary embolism (0.4%, 0.2%; HR 1.21, 95% CI = 1.01-1.45), and any thrombotic event (1.3%, 0.7%; HR 1.20, 95% CI = 1.09-1.32).</p> <p>CONCLUSIONS: Hospitalization for AF is common and frequently associated with both in-hospital complications and readmission, which were more commonly observed among women with AF. Further research into epidemiological factors and treatment differences between men and women with AF is warranted.</p>
dc.identifier.submissionpathoapubs/3665
dc.contributor.departmentDepartment of Medicine, Division of Cardiovascular Medicine


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