Clinical-epidemiological aspects, hospitalization, and reconsultations in older patients with atrial fibrillation in emergency departments in Spain (EDEN-35 study): sex-disaggregated analysis

Objective.

To assess, from a sex/gender perspective, the incidence bof atrial fibrillation (AF) in older patients in Spanish hospital emergency departments (EDs), their clinical characteristics, need for hospitalization, short-term follow-up consultations, long-term readmissions and mortality, and associated factors.

Methods.

We included all patients aged $ 65 years diagnosed with AF in 52 Spanish EDs over a 1-week period. The outcome variables were the need for hospitalization, all-cause follow-up consultations within 30 days following discharge, and long-term readmissions and mortality. A total of 29 sociodemographic and clinical variables associated with these outcomes were analyzed using adjusted models, both overall and sex-disaggregated.

Results.

A total of 676 patients with AF were identified, 55% of whom were women (annual incidence rate: 15.5 per 1,000 inhabitants aged $ 65 years (95%CI, 15.5–15.7; no differences were reported between sexes). Women were older. Overall comorbidity was high and more common in men. Hospitalization was required in 45.5% of cases, more frequently in men (51.1% vs 41.3%; p = .013 in the multivariable analysis). Within the first 30 days, 22.7% of patients had a follow-up consultation, with no differences between sexes. After a median follow-up of 1,186 days, a total of 346 patients (52.7%) were admitted at least once and 224 (34.1%) died with no significant sex differences in
either event. Most factors associated with the 4 outcome variables varied by sex.

Conclusions.

AF is a common diagnosis among older patients attending EDs, with equal incidence rates in men and women. Sex differences were found in hospitalization, but not early reconsultation, or long-term admission, or mortality, although the associated factors did vary by sex.