Sex-based disparities and in-hospital outcomes of patients hospitalized with atrial fibrillation with and without dementia.

Autor:	Baral N; Department of Internal Medicine, McLaren Flint/Michigan State University College of Human Medicine, Flint, MI, USA., Mitchell JD; Department of Internal Medicine, Division of Cardiology, Washington University in St. Louis, Saint Louis, MO, USA., Aggarwal NT; Department of Neurological Sciences, Rush Alzheimer's Disease Center, Rush University-Rush Medical College, Chicago, IL, USA., Paul TK; Department of Cardiovascular Sciences, University of Tennessee College of Medicine, Nashville, TN, USA., Seri A; Department of Internal Medicine, McLaren Flint/Michigan State University College of Human Medicine, Flint, MI, USA., Arida AK; Department of Internal Medicine, McLaren Flint/Michigan State University College of Human Medicine, Flint, MI, USA., Sud P; Department of Internal Medicine, McLaren Flint/Michigan State University College of Human Medicine, Flint, MI, USA., Kunadi A; Department of Internal Medicine, McLaren Flint/Michigan State University College of Human Medicine, Flint, MI, USA., Bashyal KP; Department of Internal Medicine, McLaren Flint/Michigan State University College of Human Medicine, Flint, MI, USA., Baral N; Department of Microbiology, Manipal College of Medical Sciences, Pokhara, Nepal., Adhikari G; Department of Medicine, University of Arizona College of Medicine, Tucson, AZ, USA., Tracy M; Department of Internal Medicine, Division of Cardiology, RUSH University-Rush Medical College, Chicago, IL, USA., Volgman AS; Department of Internal Medicine, Division of Cardiology, RUSH University-Rush Medical College, Chicago, IL, USA.
Jazyk:	angličtina
Zdroj:	American heart journal plus : cardiology research and practice [Am Heart J Plus] 2023 Feb 03; Vol. 26, pp. 100266. Date of Electronic Publication: 2023 Feb 03 (Print Publication: 2023).
DOI:	10.1016/j.ahjo.2023.100266
Abstrakt:	Study Objective: We sought to evaluate the sex-based disparities and comparative in-hospital outcomes of principal AF hospitalizations in patients with and without dementia, which have not been well-studied. Design: This is a non-interventional retrospective cohort study. Setting and Participants: We identified principal hospitalizations of AF in the National Inpatient Sample in adults (≥18 years old) between January 2016 and December 2019. Main Outcome Measure: In-hospital mortality. Results: Of 378,230 hospitalized patients with AF, 49.2 % (n = 186,039) were females and 6.1 % (n = 22,904) had dementia. The mean age (SD) was 71 (13) years. Patients with dementia had higher odds of in-hospital mortality {adjusted odds ratio (aOR): 1.48, 95 % confidence interval (CI): 1.34, 1.64, p < 0.001} and nontraumatic intracerebral hemorrhage (aOR: 1.60, 95 % CI: 1.04, 2.47, p = 0.032), but they had lower odds of catheter ablation (0.39, 95 % CI: 0.35, 0.43, p < 0.001) and electrical cardioversion (aOR: 0.33, 95 % CI: 0.31, 0.35, p < 0.001). In patients with AF and dementia, compared to males, females had similar in-hospital mortality (aOR: 1.00, 95 % CI: 0.93, 1.07, p = 0.960), fewer gastrointestinal bleeds (aOR: 0.92, 95 % CI: 0.85, 0.99, p = 0.033), lower odds of getting catheter ablation (aOR: 0.79, 95 % CI: 0.76, 0.81, p < 0.001), and less likelihood of getting electrical cardioversion (aOR: 0.78, 95 % CI: 0.76, 0.79, p < 0.001). Conclusions: Patients with AF and dementia have higher mortality and a lower likelihood of getting catheter ablation and electrical cardioversion. Competing Interests: Volgman – Sanofi (consulting), Pfizer (consulting), Merck (Consulting), Janssen (consulting), Bristol Myers Squibb Foundation Diverse Clinical Investigator Career Development Program (DCICDP), National Advisory Committee (NAC), Novartis Clinical Trial – Horizon Study, Apple Inc. stock.Mitchell – Pfizer (consulting), BridgeBio (consulting). Research support from Pfizer, Bristol Meyers Squibb, Myocardial Solutions, Abbott Laboratories, and the Children's Discovery Institute are all unrelated to the manuscript's contents. (© 2023 The Authors.)
Databáze:	MEDLINE
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