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Vol. 217. Issue 6.
Pages 309-314 (August - September 2017)
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Vol. 217. Issue 6.
Pages 309-314 (August - September 2017)
Original article
Characteristics and temporal pattern of readmissions of patients with atrial fibrillation hospitalized in medical departments
Características y patrón temporal de reingresos de los pacientes con fibrilación auricular hospitalizados en servicios médicos
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I. Iñiguez Vázquez
Corresponding author
iriainhiguez@hotmail.com

Corresponding author.
, R. Monte Secades, M. Matesanz Fernández, E.M. Romay Lema, D. Rubal Bran, E. Casariego Vales
Servicio de Medicina Interna, Hospital Lucus Augusti, Lugo, Galicia, Spain
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Tables (4)
Table 1. Characteristics of patients with and without atrial fibrillation in their first hospitalization.
Table 2. Clinical characteristics of patients with atrial fibrillation according to the order of hospitalization.
Table 3. Primary and secondary diagnoses associated with atrial fibrillation depending on the order of hospitalization.
Table 4. Distribution of medical departments at admission for patients with atrial fibrillation according to the order of hospitalization.
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Abstract
Objective

To determine the characteristics of patients with auricular fibrillation (AF) in the hospital setting and their successive hospitalisations.

Method

A retrospective cohort study was conducted on all hospital admissions in the medical area of hospital of Lugo between January 1, 2000 and December 31, 2013. The data source was the centre's minimum basic data set.

Results

A total of 149,271 hospital admissions corresponding to 66,286 patients were recorded. Of the total, the percentage of admissions and patients with AF was 17.3% (25,870) and 18.9% (12,512), respectively. The patients with AF were characterized by a larger proportion of women (49.7 vs. 44.3%; p<.0001), advanced age (78.3 [DE 10.2] vs. 67.1 years [DE 17.9]; p<.0001), more chronic diseases (4.2 [DE 2.1] vs. 2.9 [DE 1.9]; p<.001), longer hospital stays (12.5 [DE 12.5] vs. 10.6 [DE 19.9] days; p<.0001) and a high rate of readmissions (3.0 [DE 2.75] vs. 2.1 [DE 2.28]; p<.001), with a progressive shortening of the time between hospitalisations. The department of internal medicine was responsible for the care of more than half of the patients with AF. The most common associated secondary diagnoses were chronic obstructive pulmonary disease, stroke, heart failure, ischemic heart disease, other respiratory system diseases and arterial hypertension.

Conclusions

AF occurs in highly complex patients, who are mostly hospitalized in internal medicine departments, and is associated with a high rate of readmissions. We need to consider the diseases associated with AF for an overall approach to these patients.

Keywords:
Atrial fibrillation
Multimorbidity
Polypathological
Cluster
Resumen
Objetivo

Conocer las características de los pacientes con fibrilación auricular (FA) en el ámbito hospitalario y sus sucesivos ingresos.

Método

Estudio retrospectivo de cohortes con la totalidad de los ingresos hospitalarios en el área médica del hospital de Lugo entre el 1 de enero de 2000 y el 31 de diciembre de 2013. La fuente de información fue el conjunto mínimo básico de datos del centro.

Resultados

Se registraron 149.271 ingresos hospitalarios correspondientes a 66.286 pacientes. Con respecto al total, el porcentaje de ingresos y pacientes con FA fue del 17,3% (25.870) y 18,9% (12.512), respectivamente. Los pacientes con FA se caracterizaron por una mayor proporción de mujeres (49,7 frente a 44,3%; p<0,0001), mayor edad (78,3 [DE 10,2] frente a 67,1 años [DE 17,9]; p<0,0001), más enfermedades crónicas (4,2 [DE 2,1] frente a 2,9 [DE 1,9]; p<0,001), estancia hospitalaria más prolongada (12,5 [DE 12,5] frente a 10,6 días [DE 19,9]; p<0,0001) y una elevada tasa de reingresos (3,0 [DE 2,75] frente a 2,1 [DE 2,28]; p<0,001), con un acortamiento progresivo del tiempo entre ingresos. El servicio de Medicina Interna asumió la atención de más de la mitad de los enfermos con FA. Los diagnósticos secundarios asociados más frecuentes fueron: enfermedad pulmonar obstructiva crónica, ictus, insuficiencia cardiaca, cardiopatía isquémica, otras enfermedades del aparato respiratorio e hipertensión arterial.

Conclusiones

La FA se presenta en pacientes de alta complejidad, ingresados mayoritariamente en servicios de Medicina Interna, y se asocia a una elevada tasa de reingresos. Es preciso considerar las enfermedades asociadas a la FA que permitan un enfoque global de estos pacientes.

Palabras clave:
Fibrilación auricular
Multimorbilidad
Pluripatológico
Clúster

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