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Emergency Department Re-Presentation for Atrial Fibrillation and Atrial Flutter
Abstract Background Identification and appropriate management of patients with atrial fibrillation (AF) is critical to mitigate the consequences of the disease. We sought to assess the frequency and pattern of the emergency department (ED) use by patients who presented with AF and/or atrial flutter...
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| Published in: | Canadian journal of cardiology 2016-03, Vol.32 (3), p.344-348 |
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| container_end_page | 348 |
| container_issue | 3 |
| container_start_page | 344 |
| container_title | Canadian journal of cardiology |
| container_volume | 32 |
| creator | Redfearn, Damian P., MD Furqan, Muhammad Ali, BSc Enriquez, Andres, MD Barber, David Shaw, Cathy, RCT Simpson, Christopher, MD Baranchuk, Adrian, MD Michael, Kevin, MD Abdollah, Hoshiar, MB, ChB Brison, Robert J., MD, MPH |
| description | Abstract Background Identification and appropriate management of patients with atrial fibrillation (AF) is critical to mitigate the consequences of the disease. We sought to assess the frequency and pattern of the emergency department (ED) use by patients who presented with AF and/or atrial flutter (AFL) in a midsized Canadian hospital. Methods We conducted a retrospective cohort analysis of patients who presented to the ED with AF and/or AFL during the calendar years 2010-2012. Patients were identified using the MUSE (General Electric Healthcare, Bucks, United Kingdom) electrocardiogram database and matched with the National Ambulatory Care Reporting System and Discharge Abstract Database up to and including December 31, 2013, a follow-up period of 12 months. The number of presentations and time between visits was assessed. Admissions were identified and lengths of stay and reason for admission were recorded. Results We identified 1361 patients who represented a total of 4783 visits to the ED, a mean of 2.8 ± 2.9 visits per patient with 949 (69.7%) who returned for a subsequent ED visit in the subsequent 12 months. Mean time between base and subsequent visits was 136.8 ± 114.2 days. ED visits generated 1462 admissions (63.0% at repeat ED visits); mean length of stay was 9.7 ± 16.0 days. Stroke or transient ischemic attack accounted for 80 return visits and 8 deaths in 77 patients, 74% of whom with subtherapeutic or no anticoagulation medication. Conclusions Presentation to the ED with AF and/or AFL, either as a primary reason for consultation or as a secondary diagnosis, was associated with a high risk of subsequent re-presentation and hospital admission. |
| doi_str_mv | 10.1016/j.cjca.2015.08.006 |
| format | article |
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We sought to assess the frequency and pattern of the emergency department (ED) use by patients who presented with AF and/or atrial flutter (AFL) in a midsized Canadian hospital. Methods We conducted a retrospective cohort analysis of patients who presented to the ED with AF and/or AFL during the calendar years 2010-2012. Patients were identified using the MUSE (General Electric Healthcare, Bucks, United Kingdom) electrocardiogram database and matched with the National Ambulatory Care Reporting System and Discharge Abstract Database up to and including December 31, 2013, a follow-up period of 12 months. The number of presentations and time between visits was assessed. Admissions were identified and lengths of stay and reason for admission were recorded. Results We identified 1361 patients who represented a total of 4783 visits to the ED, a mean of 2.8 ± 2.9 visits per patient with 949 (69.7%) who returned for a subsequent ED visit in the subsequent 12 months. Mean time between base and subsequent visits was 136.8 ± 114.2 days. ED visits generated 1462 admissions (63.0% at repeat ED visits); mean length of stay was 9.7 ± 16.0 days. Stroke or transient ischemic attack accounted for 80 return visits and 8 deaths in 77 patients, 74% of whom with subtherapeutic or no anticoagulation medication. Conclusions Presentation to the ED with AF and/or AFL, either as a primary reason for consultation or as a secondary diagnosis, was associated with a high risk of subsequent re-presentation and hospital admission.</description><identifier>ISSN: 0828-282X</identifier><identifier>EISSN: 1916-7075</identifier><identifier>DOI: 10.1016/j.cjca.2015.08.006</identifier><identifier>PMID: 26683789</identifier><language>eng</language><publisher>England: Elsevier Inc</publisher><subject>Aged ; Anti-Arrhythmia Agents - therapeutic use ; Atrial Fibrillation - complications ; Atrial Fibrillation - drug therapy ; Atrial Fibrillation - physiopathology ; Atrial Flutter - complications ; Atrial Flutter - drug therapy ; Atrial Flutter - physiopathology ; Canada - epidemiology ; Cardiovascular ; Electrocardiography ; Emergency Service, Hospital ; Female ; Humans ; Incidence ; Male ; Patient Readmission - trends ; Prognosis ; Retrospective Studies ; Risk Factors ; Stroke - epidemiology ; Stroke - etiology ; Stroke - prevention & control ; Survival Rate - trends</subject><ispartof>Canadian journal of cardiology, 2016-03, Vol.32 (3), p.344-348</ispartof><rights>Canadian Cardiovascular Society</rights><rights>2016 Canadian Cardiovascular Society</rights><rights>Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-ec9466382f86b5de65f5446585b9efebe075095b0988b27ff64d49f2bd549a293</citedby><cites>FETCH-LOGICAL-c411t-ec9466382f86b5de65f5446585b9efebe075095b0988b27ff64d49f2bd549a293</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26683789$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Redfearn, Damian P., MD</creatorcontrib><creatorcontrib>Furqan, Muhammad Ali, BSc</creatorcontrib><creatorcontrib>Enriquez, Andres, MD</creatorcontrib><creatorcontrib>Barber, David</creatorcontrib><creatorcontrib>Shaw, Cathy, RCT</creatorcontrib><creatorcontrib>Simpson, Christopher, MD</creatorcontrib><creatorcontrib>Baranchuk, Adrian, MD</creatorcontrib><creatorcontrib>Michael, Kevin, MD</creatorcontrib><creatorcontrib>Abdollah, Hoshiar, MB, ChB</creatorcontrib><creatorcontrib>Brison, Robert J., MD, MPH</creatorcontrib><title>Emergency Department Re-Presentation for Atrial Fibrillation and Atrial Flutter</title><title>Canadian journal of cardiology</title><addtitle>Can J Cardiol</addtitle><description>Abstract Background Identification and appropriate management of patients with atrial fibrillation (AF) is critical to mitigate the consequences of the disease. We sought to assess the frequency and pattern of the emergency department (ED) use by patients who presented with AF and/or atrial flutter (AFL) in a midsized Canadian hospital. Methods We conducted a retrospective cohort analysis of patients who presented to the ED with AF and/or AFL during the calendar years 2010-2012. Patients were identified using the MUSE (General Electric Healthcare, Bucks, United Kingdom) electrocardiogram database and matched with the National Ambulatory Care Reporting System and Discharge Abstract Database up to and including December 31, 2013, a follow-up period of 12 months. The number of presentations and time between visits was assessed. Admissions were identified and lengths of stay and reason for admission were recorded. Results We identified 1361 patients who represented a total of 4783 visits to the ED, a mean of 2.8 ± 2.9 visits per patient with 949 (69.7%) who returned for a subsequent ED visit in the subsequent 12 months. Mean time between base and subsequent visits was 136.8 ± 114.2 days. ED visits generated 1462 admissions (63.0% at repeat ED visits); mean length of stay was 9.7 ± 16.0 days. Stroke or transient ischemic attack accounted for 80 return visits and 8 deaths in 77 patients, 74% of whom with subtherapeutic or no anticoagulation medication. Conclusions Presentation to the ED with AF and/or AFL, either as a primary reason for consultation or as a secondary diagnosis, was associated with a high risk of subsequent re-presentation and hospital admission.</description><subject>Aged</subject><subject>Anti-Arrhythmia Agents - therapeutic use</subject><subject>Atrial Fibrillation - complications</subject><subject>Atrial Fibrillation - drug therapy</subject><subject>Atrial Fibrillation - physiopathology</subject><subject>Atrial Flutter - complications</subject><subject>Atrial Flutter - drug therapy</subject><subject>Atrial Flutter - physiopathology</subject><subject>Canada - epidemiology</subject><subject>Cardiovascular</subject><subject>Electrocardiography</subject><subject>Emergency Service, Hospital</subject><subject>Female</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Patient Readmission - trends</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Stroke - epidemiology</subject><subject>Stroke - etiology</subject><subject>Stroke - prevention & control</subject><subject>Survival Rate - trends</subject><issn>0828-282X</issn><issn>1916-7075</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNp9kUuLFTEQhYMoznX0D7iQXrrptpJO0gmIMMxDBwZGdAbche50RdL245qkhfvvTXPHWczCVRXFOYeqrwh5S6GiQOWHobKDbSsGVFSgKgD5jOyoprJsoBHPyQ4UUyVT7McJeRXjAMBp08iX5IRJqepG6R25vZww_MTZHooL3LchTTin4huWXwPG3LbJL3PhllCcpeDbsbjyXfDjeJy3c_84H9eUMLwmL1w7RnzzUE_J_dXl3fmX8ub28_X52U1pOaWpRKu5lLViTslO9CiFE5xLoUSn0WGH-QDQogOtVMca5yTvuXas6wXXLdP1KXl_zN2H5feKMZnJR4t5sRmXNRraSCWkAN5kKTtKbVhiDOjMPvipDQdDwWwgzWA2kGYDaUCZDDKb3j3kr92E_aPlH7ks-HgUYL7yj8dgovWZI_Y-oE2mX_z_8z89sdvRz9624y88YByWNcyZn6EmMgPm-_bK7ZNUAK2B0fovTy6Y6g</recordid><startdate>20160301</startdate><enddate>20160301</enddate><creator>Redfearn, Damian P., MD</creator><creator>Furqan, Muhammad Ali, BSc</creator><creator>Enriquez, Andres, MD</creator><creator>Barber, David</creator><creator>Shaw, Cathy, RCT</creator><creator>Simpson, Christopher, MD</creator><creator>Baranchuk, Adrian, MD</creator><creator>Michael, Kevin, MD</creator><creator>Abdollah, Hoshiar, MB, ChB</creator><creator>Brison, Robert J., MD, MPH</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20160301</creationdate><title>Emergency Department Re-Presentation for Atrial Fibrillation and Atrial Flutter</title><author>Redfearn, Damian P., MD ; Furqan, Muhammad Ali, BSc ; Enriquez, Andres, MD ; Barber, David ; Shaw, Cathy, RCT ; Simpson, Christopher, MD ; Baranchuk, Adrian, MD ; Michael, Kevin, MD ; Abdollah, Hoshiar, MB, ChB ; Brison, Robert J., MD, MPH</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-ec9466382f86b5de65f5446585b9efebe075095b0988b27ff64d49f2bd549a293</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Anti-Arrhythmia Agents - therapeutic use</topic><topic>Atrial Fibrillation - complications</topic><topic>Atrial Fibrillation - drug therapy</topic><topic>Atrial Fibrillation - physiopathology</topic><topic>Atrial Flutter - complications</topic><topic>Atrial Flutter - drug therapy</topic><topic>Atrial Flutter - physiopathology</topic><topic>Canada - epidemiology</topic><topic>Cardiovascular</topic><topic>Electrocardiography</topic><topic>Emergency Service, Hospital</topic><topic>Female</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Patient Readmission - trends</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Stroke - epidemiology</topic><topic>Stroke - etiology</topic><topic>Stroke - prevention & control</topic><topic>Survival Rate - trends</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Redfearn, Damian P., MD</creatorcontrib><creatorcontrib>Furqan, Muhammad Ali, BSc</creatorcontrib><creatorcontrib>Enriquez, Andres, MD</creatorcontrib><creatorcontrib>Barber, David</creatorcontrib><creatorcontrib>Shaw, Cathy, RCT</creatorcontrib><creatorcontrib>Simpson, Christopher, MD</creatorcontrib><creatorcontrib>Baranchuk, Adrian, MD</creatorcontrib><creatorcontrib>Michael, Kevin, MD</creatorcontrib><creatorcontrib>Abdollah, Hoshiar, MB, ChB</creatorcontrib><creatorcontrib>Brison, Robert J., MD, MPH</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Canadian journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Redfearn, Damian P., MD</au><au>Furqan, Muhammad Ali, BSc</au><au>Enriquez, Andres, MD</au><au>Barber, David</au><au>Shaw, Cathy, RCT</au><au>Simpson, Christopher, MD</au><au>Baranchuk, Adrian, MD</au><au>Michael, Kevin, MD</au><au>Abdollah, Hoshiar, MB, ChB</au><au>Brison, Robert J., MD, MPH</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Emergency Department Re-Presentation for Atrial Fibrillation and Atrial Flutter</atitle><jtitle>Canadian journal of cardiology</jtitle><addtitle>Can J Cardiol</addtitle><date>2016-03-01</date><risdate>2016</risdate><volume>32</volume><issue>3</issue><spage>344</spage><epage>348</epage><pages>344-348</pages><issn>0828-282X</issn><eissn>1916-7075</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Abstract Background Identification and appropriate management of patients with atrial fibrillation (AF) is critical to mitigate the consequences of the disease. We sought to assess the frequency and pattern of the emergency department (ED) use by patients who presented with AF and/or atrial flutter (AFL) in a midsized Canadian hospital. Methods We conducted a retrospective cohort analysis of patients who presented to the ED with AF and/or AFL during the calendar years 2010-2012. Patients were identified using the MUSE (General Electric Healthcare, Bucks, United Kingdom) electrocardiogram database and matched with the National Ambulatory Care Reporting System and Discharge Abstract Database up to and including December 31, 2013, a follow-up period of 12 months. The number of presentations and time between visits was assessed. Admissions were identified and lengths of stay and reason for admission were recorded. Results We identified 1361 patients who represented a total of 4783 visits to the ED, a mean of 2.8 ± 2.9 visits per patient with 949 (69.7%) who returned for a subsequent ED visit in the subsequent 12 months. Mean time between base and subsequent visits was 136.8 ± 114.2 days. ED visits generated 1462 admissions (63.0% at repeat ED visits); mean length of stay was 9.7 ± 16.0 days. Stroke or transient ischemic attack accounted for 80 return visits and 8 deaths in 77 patients, 74% of whom with subtherapeutic or no anticoagulation medication. Conclusions Presentation to the ED with AF and/or AFL, either as a primary reason for consultation or as a secondary diagnosis, was associated with a high risk of subsequent re-presentation and hospital admission.</abstract><cop>England</cop><pub>Elsevier Inc</pub><pmid>26683789</pmid><doi>10.1016/j.cjca.2015.08.006</doi><tpages>5</tpages></addata></record> |
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| ispartof | Canadian journal of cardiology, 2016-03, Vol.32 (3), p.344-348 |
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| subjects | Aged Anti-Arrhythmia Agents - therapeutic use Atrial Fibrillation - complications Atrial Fibrillation - drug therapy Atrial Fibrillation - physiopathology Atrial Flutter - complications Atrial Flutter - drug therapy Atrial Flutter - physiopathology Canada - epidemiology Cardiovascular Electrocardiography Emergency Service, Hospital Female Humans Incidence Male Patient Readmission - trends Prognosis Retrospective Studies Risk Factors Stroke - epidemiology Stroke - etiology Stroke - prevention & control Survival Rate - trends |
| title | Emergency Department Re-Presentation for Atrial Fibrillation and Atrial Flutter |
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