Wang Y F, Lu S X, Xia S J, Jia Z X, Jiang C, He L, Du X, Ma C S
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2020 Apr 24;48(4):308-314. doi: 10.3760/cma.j.cn112148-20190727-00433.
To determine the predictors of recurrent hospitalizations among atrial fibrillation (AF) patients. We analyzed data from the Chinese Atrial Fibrillation Registry (CAFR), a prospective cohort study involving non-valvular atrial fibrillation (NVAF) patients from Augest 2011 to December 2017. A total of 5 349 NVAF patients with a minimum of 48 months follow-up were included for analysis. Data including patient demographics, complications, medical and ablation history were collected. The maximum number of all-cause hospitalizations within one-year for each patient served as the primary endpoint. Patients hospitalized less than twice within one-year were defined as non-recurrent hospitalizations group, those hospitalized at least twice within one-year were definned as recurrent hospitalizations group. Logistic regression model was used to identify associated risk factors for recurrent hospitalizations. Of 5 349 NVAF patients, those hospitalized for 0, 1, 2, 3, 4 and at least 5 times within one-year was 2 703 (50.5%), 1 776 (33.2%), 642 (12.0%), 161(3.0), 52 (1.0%), 15 (0.3%), respectively. Eight hundred and seventy (16.3%) patients were included in recurrent hospitalizations group, 4 479 (83.7%) patients were included in non-recurrent hospitalizations group. Compare with non-recurrent hospitalizations group, patients in recurrent hospitalizations group was more likely to be older and female, more frequently had a history of hypertension, heart failure, coronary heart disesase, ischaemic stroke/transient ischaemic attack, diabetes mellitus, peptic ulcer, a AF duration for more than 1 year, medication including drugs for ventricular rate control, statin, angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor blocker (ARB) and higher CHA(2)DS(2)-VASc scores (0.05), but less frequently had higher education, a history of drinking, smoking and ablation (0.05). Multivariable analysis showed that age 50-64 (1.47, 95 1.20-1.80), age≥65 (1.89, 95 1.50-2.38), female (1.21, 95 1.01-1.46), hypertension history (1.42, 95 1.16-1.74), heart failure history (1.73, 95 1.37-2.18), coronary heart disease history (1.63, 95 1.31-2.03), peptic ulcer history (2.00, 95 1.18-3.39) were independent risk factors for recurrent hospitalizations, while higher education (college or above) (0.82, 95 0.69-0.99) was the protective factor for recurrent hospitalizations. Nearly 1 in 6 of AF patients were admitted to hospital more than once within one year in this NVAF cohort. Age≥50, female, hypertension history, heart failure history, coronary heart disease history, peptic ulcer history are associated with an increased risk of recurrent hospitalizations.
为确定心房颤动（AF）患者再次住院的预测因素。我们分析了来自中国心房颤动注册研究（CAFR）的数据，这是一项前瞻性队列研究，纳入了2011年8月至2017年12月的非瓣膜性心房颤动（NVAF）患者。总共纳入5349例至少随访48个月的NVAF患者进行分析。收集了包括患者人口统计学、并发症、医疗和消融病史等数据。将每位患者一年内全因住院的最大次数作为主要终点。一年内住院少于两次的患者被定义为非再住院组，一年内至少住院两次的患者被定义为再住院组。采用逻辑回归模型确定再住院的相关危险因素。在5349例NVAF患者中，一年内住院0次、1次、2次、3次、4次和至少5次的患者分别为2703例（50.5%）、1776例（33.2%）、642例（12.0%）、161例（3.0%）、52例（1.0%）、15例（0.3%）。870例（16.3%）患者被纳入再住院组，4479例（83.7%）患者被纳入非再住院组。与非再住院组相比，再住院组患者更可能年龄较大且为女性，更频繁有高血压、心力衰竭、冠心病、缺血性卒中/短暂性脑缺血发作、糖尿病、消化性溃疡病史，房颤持续时间超过1年，使用包括控制心室率药物、他汀类药物、血管紧张素转换酶抑制剂（ACEI）/血管紧张素受体阻滞剂（ARB）等药物，且CHA(2)DS(2)-VASc评分较高（P<0.05），但接受高等教育、有饮酒、吸烟和消融病史的频率较低（P<；0.05）。多变量分析显示，年龄50 - 64岁（1.47，95%CI 1.20 - 1.80）、年龄≥65岁（1.89，95%CI 1.50 - 2.38）、女性（1.21，95%CI 1.01 - 1.46）、高血压病史（1.42，95%CI 1.16 - 1.74）、心力衰竭病史（1.73，95%CI 1.37 - 2.18）、冠心病病史（1.
