Sex Differences in the Association between Atrial Fibrillation and 90-Day Adverse Outcomes among Older Adults with Heart Failure: A Retrospective Cohort Study.

Youn-Jung Son,Da-Young Kim,Mi Hwa Won

doi:10.3390/ijerph18052237

Abstract

Sex differences in the prognostic impact of coexisting atrial fibrillation (AF) in older patients with heart failure (HF) have not been well-studied. This study, therefore, compared sex differences in the association between AF and its 90-day adverse outcomes (hospital readmissions and emergency room (ER) visits) among older adults with HF. Of the 250 older adult patients, the prevalence rates of coexisting AF between male and female HF patients were 46.0% and 31.0%, respectively. In both male and female older patients, patients with AF have a significantly higher readmission rate (male 46.0%, and female 34.3%) than those without AF (male 6.8%, and female 12.8%). However, there are no significant differences in the association between AF and ER visits in both male and female older HF patients. The multivariate logistic analysis showed that coexisting AF significantly increased the risk of 90-day hospital readmission in both male and female older patients. In addition, older age in males and longer periods of time after an HF diagnosis in females were associated with an increased risk of hospital readmission. Consequently, prospective cohort studies are needed to identify the impact of coexisting AF on short- and long-term outcomes in older adult HF patients by sex.

Highlights

Heart failure (HF) is a significant global health issue and disproportionately influences older individuals [1,2,3]
Reducing unplanned hospitalizations and frequent emergency room (ER) visits is an important step towards decreasing costs while maintaining high quality of care
The current study underscored the importance of sex differences on hospital readmissions in the 90 days after discharge among older adult patients with HF and coexisting atrial fibrillation (AF)

Summary

Introduction

Heart failure (HF) is a significant global health issue and disproportionately influences older individuals [1,2,3]. Older patients are liable to developing HF because of age-related physiologic and pathologic changes [4]. The prevalence of HF is around 11.8% in those aged 65 years and over [5]. Despite the advancement of medical therapy and technology, HF is one of the most common reasons for hospitalization and results in high morbidity, mortality, and health costs in an aging population [6,7]. The one-year global HF hospital readmission rates are from 24.3% to 30.9% [8]. Readmission rates may be as high as 45%

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