Hospitalizations for about 70 percent of ER visits for A-fib

(HealthDay)—Nationwide, 69 percent of emergency department visits for atrial fibrillation (AF) result in hospitalization, with patient- and hospital-level factors affecting hospitalization, according to a study published in the Nov. 1 issue of The American Journal of Cardiology.

Tyler W. Barrett, M.D., from the Vanderbilt University Medical Center in Nashville, Tenn., and colleagues used data from the Nationwide Emergency Department Sample to estimate the percentage of adults with AF listed as the primary emergency department diagnosis resulting in hospitalization, and the correlation between prespecified patient and hospital characteristics with hospitalization.

The researchers found that there were 1,320,123 weighted emergency department visits for AF from 2007 to 2009, with a national hospitalization rate of 69 percent and regional rates of 74 percent for Northeast, 68 percent for Midwest, 74 percent for South, and 57 percent for West. Heart failure, chronic obstructive pulmonary disease, and coronary artery disease had the highest odds ratios for predicting hospitalization (3.85, 2.47, and 1.65, respectively). Compared with Medicare recipients, privately insured (0.77) and self-pay (0.77) patients had lower odds of hospitalization, while Medicaid patients had higher odds (1.21), after adjustment for age. Odds were also significantly higher for patients living in low-income zip codes (1.18) and for those treated at large metropolitan hospitals (1.75).

"Our analysis showed considerable regional variation in the management of patients with AF in the emergency department and in associations between patient socioeconomic and hospital characteristics with emergency department disposition; adapting best practices from among these variations in management could reduce hospitalizations and health care expenses," the authors write.

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