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J Clin Med. 2020;9(5):jcm9051485.

Temporal Trends of Emergency Department Visits of Patients with Atrial Fibrillation: A Nationwide Population-Based Study.

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제1저자 이소령 · 교신저자 최의근

소속 (6)
  1. Department of Internal Medicine, Seoul National University Hospital, Seoul 03080, Korea.
  2. Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, Korea.
  3. Statistics and Actuarial Science, Soongsil University, Seoul 03080, Korea.
  4. Department of Emergency Medicine, Seoul National University Hospital, Seoul 03080, Korea.
  5. Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Chest & Heart Hospital, Liverpool L143PE, UK.
  6. Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark.

Abstract

We aimed to describe temporal trends in emergency department (ED) visits of patients with atrial fibrillation (AF) over 12 years. A repeated cross-sectional analysis of ED visits in AF patients using the Korean nationwide claims database between 2006 and 2017 were conducted. We identified AF patients who had ≥1 ED visits. The incidence of ED visits among total AF population, cause of ED visit, and clinical outcomes were evaluated. During 12 years, the annual numbers of AF patients who attended ED at least once a year continuously increased (40,425 to 99,763). However, the annual incidence of ED visits of AF patients was stationary at about 30% because the number of total AF patients also increased during the same period. The most common cause of ED visits was cerebral infarction. Although patients had a higher risk profile over time, the 30-day and 90-day mortality after ED visit decreased over time. ED visits due to ischemic stroke, intracranial hemorrhage, and myocardial infarction decreased, whereas ED visits due to AF, gastrointestinal bleeding, and other major bleeding slightly increased among total AF population over 12 years. A substantial proportion of AF patients attended ED every year, and the annual numbers of AF patients who visited the ED significantly increased over 12 years. Optimized management approaches in a holistic and integrated manner should be provided to reduce ED visits of AF patients.

Keywords

atrial fibrillationemergency departmentoral anticoagulantstroke

Figures

Figure 1
Figure 1 Number of total AF population, patients who visited ED from 2006 to 2017, and incidence of emergency department visits in Korean AF population. Abbreviations: AF, atrial fibrillation; ED, emergency department.
Figure 2
Figure 2 Patient distribution by the number of ED visits each year. Abbreviation: ED, emergency department.
Figure 3
Figure 3 30 day and 90 day mortality after ED visit. Abbreviations: AF, atrial fibrillation; ED, emergency department.
Figure 4
Figure 4 Common causes of ED visits in patients with AF. Abbreviations: AF, atrial fibrillation; AMI, acute myocardial infarction; CKD, chronic kidney disease; COPD, chronic obstructive pulmonary disease; ICH, intracranial hemorrhage.
Figure 5
Figure 5 Temporal trends of incidence of ED visits from AF-related complications and OAC prescription rate among total AF population from 2006 to 2017. Abbreviations: AF, atrial fibrillation; ED, emergency department; GI, gastrointestinal; ICH, intracranial hemorrhage; NOAC, non-vitamin K antagonist oral anticoagulant; MI, myocardial infarction; OAC, oral anticoagulants.

그림 출처: PubMed Central 공개 논문 (PMC7290994)

Conflict of interest statement

S.-R.L., S.-Y.L., E.L., K.-D.H., M.-J.C., W.Y.K., S.D.S., S.O.: None. E.-K.C.: Research grant from Daiichi-Sankyo, BMS/Pfizer, and Biosense Webster. G.Y.H.L.: Consultant for Bayer/Janssen, BMS/Pfizer, Medtronic, Boehringer Ingelheim, Novartis, Verseon and Daiichi-Sankyo. Speaker for Bayer, BMS/Pfizer, Medtronic, Boehringer Ingelheim, and Daiichi-Sankyo. No fees are received personally.

그 밖의 정보
출판 형태
Journal Article
저널
Journal of clinical medicine · ISSN 2077-0383
전자 출판
2020-05-14
연구비
Korea National Research Foundation funded by the Ministry of Education, Science and Technology 2014R1A1A2A16055218
참고문헌
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