Jalloul Youssef, El Roumi Joseph, Tamim Hani, Al Sakan Moied, Eid Shaker, Refaat Marwan
Internal Medicine, American University of Beirut Medical Center, Beirut, LBN.
Cardiology, Cleveland Clinic, Ohio, USA.
Cureus. 2025 Jun 9;17(6):e85634. doi: 10.7759/cureus.85634. eCollection 2025 Jun.
Atrial fibrillation (AF) is the most common arrhythmia to affect elderly patients above 70 years of age and causes a significant burden. Multiple demographic factors have been linked to increased mortality in general in patients admitted with AF. The aim of our study is to delineate those factors in elderly patients admitted with atrial fibrillation in the United States. We used the Nationwide Inpatient Sample to evaluate the mortality of patients aged more than 70 admitted with AF between 2005 and 2014. We looked at variables such as race, sex, hospital location, hospital teaching status, hospital bed size, and hospital region to elucidate the association, if present, between those variables and mortality in our patient population. Specific ICD-9-CM codes were used to identify the study patients and their outcomes. Our results showed that 2,163,343 elderly patients above 70 years of age were admitted between 2005 and 2014, inclusive, with a diagnosis of AF. In those aged greater than 70, there was an association between sex and mortality (1.37% of females died vs. 1.48% of males died, p=0.004). However, patients who were white had a lower mortality rate than other races (1.38% of white patients died) at a p-value <0.0001. There was no correlation between hospital bed size or hospital teaching status (teaching vs. non-teaching) and mortality, with a p-value of 0.31 and 0.57, respectively. However, hospital location (1.39% mortality in urban vs. 1.51% in rural hospitals) and hospital region (the least mortality rate 1.24%, was found in Midwest and the highest, 1.58%, was found in Northeast), were associated with mortality, with corresponding p-values of 0.022 and <0.0001 respectively. The results of our analysis signify the need for further advancement of the hospital and regional-based resources. These outcomes reflect the gaps in the uniformity of nationwide medical care that the United States aims to attain.
心房颤动（AF）是影响70岁以上老年患者的最常见心律失常，会造成重大负担。多种人口统计学因素与房颤住院患者的总体死亡率增加有关。我们研究的目的是在美国确定房颤老年住院患者中的这些因素。我们使用全国住院患者样本评估2005年至2014年间70岁以上房颤住院患者的死亡率。我们研究了种族、性别、医院位置、医院教学状况、医院床位规模和医院地区等变量，以阐明这些变量与我们患者群体死亡率之间是否存在关联。使用特定的国际疾病分类第九版临床修订本（ICD-9-CM）编码来识别研究患者及其结局。我们的结果显示，2005年至2014年（含）期间，共有2163343名70岁以上的老年患者因房颤诊断入院。在70岁以上的患者中，性别与死亡率之间存在关联（女性死亡率为1.37%，男性死亡率为1.48%，p=0.004）。然而，白人患者的死亡率低于其他种族（白人患者死亡率为1.38%），p值<0.0001。医院床位规模或医院教学状况（教学医院与非教学医院）与死亡率之间无相关性，p值分别为0.31和0.57。然而，医院位置（城市医院死亡率为1.39%，农村医院为1.51%）和医院地区（中西部地区死亡率最低，为1.24%，东北地区最高，为1.58%）与死亡率相关，相应的p值分别为0.022和<0.0001。我们的分析结果表明需要进一步改善基于医院和地区的资源。这些结果反映了美国旨在实现的全国医疗服务统一性方面的差距。
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