Kalesan, BinduKundu, AmartyaVaze, AdityaPino, ElizabethWalkey, Allan JVasan, Ramachandran S.McManus, David D2022-08-232022-08-232018-11-122018-12-21<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>0160-9289 (Linking)10.1002/clc.2311130421445https://hdl.handle.net/20.500.14038/40860BACKGROUND: 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.en-USatrial fibrillationoutcomesreadmissionUMCCTS fundingCardiologyCardiovascular DiseasesClinical EpidemiologyEpidemiologyGender and SexualityHealth Services AdministrationJournal Articlehttps://escholarship.umassmed.edu/oapubs/366513525557oapubs/3665