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Trends in mortality after first hospitalization with Atrial Fibrillation diagnosis in Sweden 1987 to 2006

Journal article
Authors Lars G. Olsson
Karl Swedberg
Georg Lappas
S. Stewart
Annika Rosengren
Published in International Journal of Cardiology
Volume 170
Issue 1
Pages 75-80
ISSN 0167-5273
Publication year 2013
Published at Institute of Medicine, Department of Molecular and Clinical Medicine
Pages 75-80
Language en
Links dx.doi.org/10.1016/j.ijcard.2013.10...
https://gup.ub.gu.se/file/124866
Keywords Atrial fibrillation, Mortality, Epidemiology, ACUTE MYOCARDIAL-INFARCTION, HEART-FAILURE, CASE-FATALITY, SECULAR, TRENDS, RISK FACTOR, FOLLOW-UP, STROKE, PREVALENCE, DISCHARGE, SURVIVAL
Subject categories Epidemiology

Abstract

Background: To examine trends in 3-yearmortality after a first hospitalization with diagnosed atrial fibrillation in a large cohort with and without important comorbidities. Methods: The Swedish Hospital Discharge and Cause of Death Registries were linked to investigate trends in mortality for all patients 35 to 84 years hospitalized for the first time with a discharge diagnosis (principal or contributory) of atrial fibrillation in Sweden during 1987 to 2006. We performed an analysis of temporal trends in mortality stratified for presence or absence of co-morbidities affecting survival. Results: Exactly 376,000 patients (56% male, mean age 72years) with a first diagnosis of atrial fibrillation during 1987-2006were identified and followed for 3years. Patients with one or more of the prespecified comorbidities had the highestmortality and the largest absolute decline in mortality, but patients without these comorbidities had a slightly larger relative decline (absolute risk reduction in 3-yearmortality (AAR) from42.5 to 34.7%, Hazard Ratio (HR) 0.76; 95% confidence interval (95% CI) 0.74 to 0.77 versus ARR 16.2% to 11.7%, HR 0.71; 0.68 to 0.74. In patients aged below 65years, with no comorbidities, therewasminimal change inmortality, and they still had a 2 times increased mortality compared to the general population (SMR 1.95; 1.84-2.06). Conclusions: Survival after a first hospitalization with a diagnosis of atrial fibrillation improved regardless comorbidities. Patients agedb65years old without diagnosed comorbidities still had a poor prognosis compared to the general population. c 2013 Elsevier Ireland Ltd. All rights reserved.

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