Abstract
BackgroundMortality data of non-critically ill patients presenting with symptomatic atrial fibrillation to an emergency department are scarce. We aimed to analyze the short-term mortality of these patients compared with that of the general Austrian population.Design/methodsThis study analyzed a consecutive series of non-critically ill adults presenting to the emergency department at the Medical University of Vienna between 2012 and 2016 with complaints related to atrial fibrillation. The study outcome was mortality during the observation period. Age-specific and sex-specific mortality rates per 100 person-years were calculated and compared with the mortality rates of the Austrian population during the same period.ResultsIn total, 1754 patients with atrial fibrillation (43.1% female) were included in the study. During a median follow-up of 25 months, 248 of these patients died. Observed mortality rates were 7.8 per 100 person-years for females (95% confidence interval, CI 6.6–9.5) and 5.9 per 100 person-years for males (95% CI 5.0–7.1). Age-adjusted and sex-adjusted mortality rates were 2.8 (95% CI 2.3–3.3) and 2.7 (95% CI 2.2–3.2) per 100 person-years, respectively. Mortality rates for the Austrian population were 1.1 per 100 person-years for both females and males. Corresponding standardized mortality ratios were 2.5 for females (95% CI 2.1–3.0) and 2.4 for males (95% CI 2.0–2.9).ConclusionThe short-term mortality of patients with symptomatic atrial fibrillation presenting to the emergency department was substantially higher compared with the general Austrian population.Supplementary InformationThe online version of this article (10.1007/s00508-021-01895-y) contains supplementary material, which is available to authorized users.
Highlights
Identifying vulnerable, high-risk patients and specific subgroups is crucial for personalized medicine [1]
The mortality rates of both female (7.8 per 100 person-years, 95% confidence intervals (CI): 6.6–9.5) and male (5.9 per 100 person-years, 95% CI: 5.0–7.1) patients with symptomatic atrial fibrillation (AF) presenting to the emergency department (ED) was significantly higher than the mortality rate of the general Austrian population (1.1 for both sexes per 100 person-years; p < 0.001; Fig. 1)
Age-adjusted and sex-adjusted mortality rates of AF patients were 2.8 and 2.7 per 100 person-years, respectively
Summary
Identifying vulnerable, high-risk patients and specific subgroups is crucial for personalized medicine [1]. Risk management is difficult because this population varies widely in epidemiology, etiology, and comorbidities [2]. A widely cited study including a broad AF population reported a twofold increased risk of all-cause mortality in females and a 1.5-fold increased risk in males [4]. Whether these results apply to subgroups, such as patients with symptomatic AF in the emergency department (ED) is unknown. Because acute AF is rarely life-threatening in the ED, the vulnerability of these patients may not be fully recognized. The present study sought to evaluate the relative mortality of patients presenting
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