Socioeconomic Differences in Outcomes after Hospital Admission for Atrial Fibrillation or Flutter
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Socioeconomic Differences in Outcomes after Hospital Admission for Atrial Fibrillation or Flutter. / Hagengaard, Louise; Andersen, Mikkel Porsborg; Polcwiartek, Christoffer; Larsen, Jacob Mosgaard; Larsen, Mogens Lytken; Skals, Regitze Kuhr; Hansen, Steen Møller; Riahi, Sam; Gislason, Gunnar; Torp-Pedersen, Christian; Søgaard, Peter; Kragholm, Kristian Hay.
In: European Heart Journal - Quality of Care and Clinical Outcomes, Vol. 7, No. 3, 2021, p. 295–303.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Socioeconomic Differences in Outcomes after Hospital Admission for Atrial Fibrillation or Flutter
AU - Hagengaard, Louise
AU - Andersen, Mikkel Porsborg
AU - Polcwiartek, Christoffer
AU - Larsen, Jacob Mosgaard
AU - Larsen, Mogens Lytken
AU - Skals, Regitze Kuhr
AU - Hansen, Steen Møller
AU - Riahi, Sam
AU - Gislason, Gunnar
AU - Torp-Pedersen, Christian
AU - Søgaard, Peter
AU - Kragholm, Kristian Hay
PY - 2021
Y1 - 2021
N2 - AIMS: To examine socioeconomic differences in care and outcomes in a one-year period beginning 30 days after hospital discharge for first-time AF hospitalization.METHODS AND RESULTS: This nationwide register-based follow-up cohort study investigated AF 30-day discharge survivors in Denmark during 2005-2014 and examined associations between patient's socioeconomic status (SES) and selected outcomes during a 1-year follow-up period beginning 30 days post-discharge after first-time hospitalization for AF. Patient SES was defined in four groups (lowest, second lowest, second highest and highest) according to each patient's equivalized income. SES of the included 150,544 patients was: 27.7% lowest (n = 41,648), 28.1% second lowest (n = 42,321), 23.7% second highest (n = 35,656) and 20.5% highest (n = 30,919). Patients of lowest SES were older and more often women. Within 1-year follow-up, patients of lowest SES were less often re-hospitalized or seen in outpatient clinics due to AF, or treated with cardioversion or ablation, and were slightly more often diagnosed with stroke and heart failure and significantly more likely to die (16.1% vs. 14.9%, 11.3% and 8.1%). Hazard ratios for all-cause mortality were 0.64 (95% CI 0.61-0.68) for highest vs. lowest SES, adjusted for CHA2DS2-VASc-score, COPD, rate- and rhythm-controlling drugs and cohabitation status.CONCLUSION: In 30-day survivors of first-time hospitalization due to AF, lowest SES is associated with increased 1-year all-cause and cardiovascular mortality and fewer cardioversions, ablations, readmissions and outpatient contacts due to AF. Our findings indicate a need for socially differentiated rehabilitation following hospital discharge for first-time AF.
AB - AIMS: To examine socioeconomic differences in care and outcomes in a one-year period beginning 30 days after hospital discharge for first-time AF hospitalization.METHODS AND RESULTS: This nationwide register-based follow-up cohort study investigated AF 30-day discharge survivors in Denmark during 2005-2014 and examined associations between patient's socioeconomic status (SES) and selected outcomes during a 1-year follow-up period beginning 30 days post-discharge after first-time hospitalization for AF. Patient SES was defined in four groups (lowest, second lowest, second highest and highest) according to each patient's equivalized income. SES of the included 150,544 patients was: 27.7% lowest (n = 41,648), 28.1% second lowest (n = 42,321), 23.7% second highest (n = 35,656) and 20.5% highest (n = 30,919). Patients of lowest SES were older and more often women. Within 1-year follow-up, patients of lowest SES were less often re-hospitalized or seen in outpatient clinics due to AF, or treated with cardioversion or ablation, and were slightly more often diagnosed with stroke and heart failure and significantly more likely to die (16.1% vs. 14.9%, 11.3% and 8.1%). Hazard ratios for all-cause mortality were 0.64 (95% CI 0.61-0.68) for highest vs. lowest SES, adjusted for CHA2DS2-VASc-score, COPD, rate- and rhythm-controlling drugs and cohabitation status.CONCLUSION: In 30-day survivors of first-time hospitalization due to AF, lowest SES is associated with increased 1-year all-cause and cardiovascular mortality and fewer cardioversions, ablations, readmissions and outpatient contacts due to AF. Our findings indicate a need for socially differentiated rehabilitation following hospital discharge for first-time AF.
U2 - 10.1093/ehjqcco/qcz053
DO - 10.1093/ehjqcco/qcz053
M3 - Journal article
C2 - 31560375
VL - 7
SP - 295
EP - 303
JO - European Heart Journal - Quality of Care and Clinical Outcomes
JF - European Heart Journal - Quality of Care and Clinical Outcomes
SN - 2058-5225
IS - 3
ER -
ID: 237703467