Prevalence and outcomes of atrial fibrillation in older people living in care homes in Wales: a routine data linkage study 2003-2018
To determine atrial fibrillation (AF) prevalence and temporal trends, and examine associations between AF and risk of adverse health outcomes in older care home residents. Retrospective cohort study using anonymised linked data from the Secure Anonymised Information Linkage Databank on CARE home res...
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| Veröffentlicht in: | Age and ageing 2022-12, Vol.51 (12) |
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| creator | Ritchie, Leona A Harrison, Stephanie L Penson, Peter E Akbari, Ashley Torabi, Fatemeh Hollinghurst, Joe Harris, Daniel Oke, Oluwakayode B Akpan, Asangaedem Halcox, Julian P Rodgers, Sarah E Lip, Gregory Y H Lane, Deirdre A |
| description | To determine atrial fibrillation (AF) prevalence and temporal trends, and examine associations between AF and risk of adverse health outcomes in older care home residents.
Retrospective cohort study using anonymised linked data from the Secure Anonymised Information Linkage Databank on CARE home residents in Wales with AF (SAIL CARE-AF) between 2003 and 2018. Fine-Gray competing risk models were used to estimate the risk of health outcomes with mortality as a competing risk. Cox regression analyses were used to estimate the risk of mortality.
There were 86,602 older care home residents (median age 86.0 years [interquartile range 80.8-90.6]) who entered a care home between 2003 and 2018. When the pre-care home entry data extraction was standardised, the overall prevalence of AF was 17.4% (95% confidence interval 17.1-17.8) between 2010 and 2018. There was no significant change in the age- and sex-standardised prevalence of AF from 16.8% (15.9-17.9) in 2010 to 17.0% (16.1-18.0) in 2018. Residents with AF had a significantly higher risk of cardiovascular mortality (adjusted hazard ratio [HR] 1.27 [1.17-1.37], P |
| doi_str_mv | 10.1093/ageing/afac252 |
| format | Article |
| fullrecord | <record><control><sourceid>pubmed_cross</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9721338</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>36469091</sourcerecordid><originalsourceid>FETCH-LOGICAL-c390t-779ad8ceb3a1708e6d8ffb7b1d0a7e586eca64a756dccf090e1834e8efea54ba3</originalsourceid><addsrcrecordid>eNpVkclKBDEQhoMoOi5Xj5IXaM3SS9qDIOIGgh4Uj011UhmjmWRI9wzM3Qc3Oip6Kmr5vyrqJ-SQs2POWnkCU3RhegIWtKjEBpnwslaFULLcJBPGmChYI9odsjsMrznlFRfbZEfWZd2ylk_I-0PCJXgMGikEQ-Ni1HGGA42WwpgceGpdn5z3MLoYqAs0eoOJzjHOPVLvlnn_Z1lDQvrypc3Zc2YOpxRoykQXkBoYIU-Ht3wxHcaFWVHBmCwE42qfbFnwAx58xz3ydHX5eHFT3N1f316c3xVatmwsmqYFozT2EnjDFNZGWds3PTcMGqxUjRrqEpqqNlpb1jLk-Q-o0CJUZQ9yj5ytufNFP0OjMYwJfDdPbgZp1UVw3f9OcC_dNC67thFcSpUBx2uATnEYEtpfLWfdpx_d2o_u248sOPq78Xf8xwD5AaDpjCU</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Prevalence and outcomes of atrial fibrillation in older people living in care homes in Wales: a routine data linkage study 2003-2018</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Ritchie, Leona A ; Harrison, Stephanie L ; Penson, Peter E ; Akbari, Ashley ; Torabi, Fatemeh ; Hollinghurst, Joe ; Harris, Daniel ; Oke, Oluwakayode B ; Akpan, Asangaedem ; Halcox, Julian P ; Rodgers, Sarah E ; Lip, Gregory Y H ; Lane, Deirdre A</creator><creatorcontrib>Ritchie, Leona A ; Harrison, Stephanie L ; Penson, Peter E ; Akbari, Ashley ; Torabi, Fatemeh ; Hollinghurst, Joe ; Harris, Daniel ; Oke, Oluwakayode B ; Akpan, Asangaedem ; Halcox, Julian P ; Rodgers, Sarah E ; Lip, Gregory Y H ; Lane, Deirdre A</creatorcontrib><description>To determine atrial fibrillation (AF) prevalence and temporal trends, and examine associations between AF and risk of adverse health outcomes in older care home residents.
Retrospective cohort study using anonymised linked data from the Secure Anonymised Information Linkage Databank on CARE home residents in Wales with AF (SAIL CARE-AF) between 2003 and 2018. Fine-Gray competing risk models were used to estimate the risk of health outcomes with mortality as a competing risk. Cox regression analyses were used to estimate the risk of mortality.
There were 86,602 older care home residents (median age 86.0 years [interquartile range 80.8-90.6]) who entered a care home between 2003 and 2018. When the pre-care home entry data extraction was standardised, the overall prevalence of AF was 17.4% (95% confidence interval 17.1-17.8) between 2010 and 2018. There was no significant change in the age- and sex-standardised prevalence of AF from 16.8% (15.9-17.9) in 2010 to 17.0% (16.1-18.0) in 2018. Residents with AF had a significantly higher risk of cardiovascular mortality (adjusted hazard ratio [HR] 1.27 [1.17-1.37], P < 0.001), all-cause mortality (adjusted HR 1.14 [1.11-1.17], P < 0.001), ischaemic stroke (adjusted sub-distribution HR 1.55 [1.36-1.76], P < 0.001) and cardiovascular hospitalisation (adjusted sub-distribution HR 1.28 [1.22-1.34], P < 0.001).
Older care home residents with AF have an increased risk of adverse health outcomes, even when higher mortality rates and other confounders are accounted for. This re-iterates the need for appropriate oral anticoagulant prescription and optimal management of cardiovascular co-morbidities, irrespective of frailty status and predicted life expectancy.</description><identifier>ISSN: 0002-0729</identifier><identifier>EISSN: 1468-2834</identifier><identifier>DOI: 10.1093/ageing/afac252</identifier><identifier>PMID: 36469091</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Aged ; Aged, 80 and over ; Anticoagulants - adverse effects ; Atrial Fibrillation - diagnosis ; Atrial Fibrillation - epidemiology ; Brain Ischemia ; Humans ; Information Storage and Retrieval ; Prevalence ; Research Paper ; Retrospective Studies ; Risk Factors ; Stroke - diagnosis ; Stroke - epidemiology ; Wales - epidemiology</subject><ispartof>Age and ageing, 2022-12, Vol.51 (12)</ispartof><rights>The Author(s) 2022. Published by Oxford University Press on behalf of the British Geriatrics Society.</rights><rights>The Author(s) 2022. Published by Oxford University Press on behalf of the British Geriatrics Society. 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c390t-779ad8ceb3a1708e6d8ffb7b1d0a7e586eca64a756dccf090e1834e8efea54ba3</citedby><cites>FETCH-LOGICAL-c390t-779ad8ceb3a1708e6d8ffb7b1d0a7e586eca64a756dccf090e1834e8efea54ba3</cites><orcidid>0000-0001-6763-1489 ; 0000-0002-8846-0946 ; 0000-0002-0392-1767 ; 0000-0002-3556-2017</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36469091$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ritchie, Leona A</creatorcontrib><creatorcontrib>Harrison, Stephanie L</creatorcontrib><creatorcontrib>Penson, Peter E</creatorcontrib><creatorcontrib>Akbari, Ashley</creatorcontrib><creatorcontrib>Torabi, Fatemeh</creatorcontrib><creatorcontrib>Hollinghurst, Joe</creatorcontrib><creatorcontrib>Harris, Daniel</creatorcontrib><creatorcontrib>Oke, Oluwakayode B</creatorcontrib><creatorcontrib>Akpan, Asangaedem</creatorcontrib><creatorcontrib>Halcox, Julian P</creatorcontrib><creatorcontrib>Rodgers, Sarah E</creatorcontrib><creatorcontrib>Lip, Gregory Y H</creatorcontrib><creatorcontrib>Lane, Deirdre A</creatorcontrib><title>Prevalence and outcomes of atrial fibrillation in older people living in care homes in Wales: a routine data linkage study 2003-2018</title><title>Age and ageing</title><addtitle>Age Ageing</addtitle><description>To determine atrial fibrillation (AF) prevalence and temporal trends, and examine associations between AF and risk of adverse health outcomes in older care home residents.
Retrospective cohort study using anonymised linked data from the Secure Anonymised Information Linkage Databank on CARE home residents in Wales with AF (SAIL CARE-AF) between 2003 and 2018. Fine-Gray competing risk models were used to estimate the risk of health outcomes with mortality as a competing risk. Cox regression analyses were used to estimate the risk of mortality.
There were 86,602 older care home residents (median age 86.0 years [interquartile range 80.8-90.6]) who entered a care home between 2003 and 2018. When the pre-care home entry data extraction was standardised, the overall prevalence of AF was 17.4% (95% confidence interval 17.1-17.8) between 2010 and 2018. There was no significant change in the age- and sex-standardised prevalence of AF from 16.8% (15.9-17.9) in 2010 to 17.0% (16.1-18.0) in 2018. Residents with AF had a significantly higher risk of cardiovascular mortality (adjusted hazard ratio [HR] 1.27 [1.17-1.37], P < 0.001), all-cause mortality (adjusted HR 1.14 [1.11-1.17], P < 0.001), ischaemic stroke (adjusted sub-distribution HR 1.55 [1.36-1.76], P < 0.001) and cardiovascular hospitalisation (adjusted sub-distribution HR 1.28 [1.22-1.34], P < 0.001).
Older care home residents with AF have an increased risk of adverse health outcomes, even when higher mortality rates and other confounders are accounted for. This re-iterates the need for appropriate oral anticoagulant prescription and optimal management of cardiovascular co-morbidities, irrespective of frailty status and predicted life expectancy.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anticoagulants - adverse effects</subject><subject>Atrial Fibrillation - diagnosis</subject><subject>Atrial Fibrillation - epidemiology</subject><subject>Brain Ischemia</subject><subject>Humans</subject><subject>Information Storage and Retrieval</subject><subject>Prevalence</subject><subject>Research Paper</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Stroke - diagnosis</subject><subject>Stroke - epidemiology</subject><subject>Wales - epidemiology</subject><issn>0002-0729</issn><issn>1468-2834</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkclKBDEQhoMoOi5Xj5IXaM3SS9qDIOIGgh4Uj011UhmjmWRI9wzM3Qc3Oip6Kmr5vyrqJ-SQs2POWnkCU3RhegIWtKjEBpnwslaFULLcJBPGmChYI9odsjsMrznlFRfbZEfWZd2ylk_I-0PCJXgMGikEQ-Ni1HGGA42WwpgceGpdn5z3MLoYqAs0eoOJzjHOPVLvlnn_Z1lDQvrypc3Zc2YOpxRoykQXkBoYIU-Ht3wxHcaFWVHBmCwE42qfbFnwAx58xz3ydHX5eHFT3N1f316c3xVatmwsmqYFozT2EnjDFNZGWds3PTcMGqxUjRrqEpqqNlpb1jLk-Q-o0CJUZQ9yj5ytufNFP0OjMYwJfDdPbgZp1UVw3f9OcC_dNC67thFcSpUBx2uATnEYEtpfLWfdpx_d2o_u248sOPq78Xf8xwD5AaDpjCU</recordid><startdate>20221205</startdate><enddate>20221205</enddate><creator>Ritchie, Leona A</creator><creator>Harrison, Stephanie L</creator><creator>Penson, Peter E</creator><creator>Akbari, Ashley</creator><creator>Torabi, Fatemeh</creator><creator>Hollinghurst, Joe</creator><creator>Harris, Daniel</creator><creator>Oke, Oluwakayode B</creator><creator>Akpan, Asangaedem</creator><creator>Halcox, Julian P</creator><creator>Rodgers, Sarah E</creator><creator>Lip, Gregory Y H</creator><creator>Lane, Deirdre A</creator><general>Oxford University Press</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>5PM</scope><orcidid>https://orcid.org/0000-0001-6763-1489</orcidid><orcidid>https://orcid.org/0000-0002-8846-0946</orcidid><orcidid>https://orcid.org/0000-0002-0392-1767</orcidid><orcidid>https://orcid.org/0000-0002-3556-2017</orcidid></search><sort><creationdate>20221205</creationdate><title>Prevalence and outcomes of atrial fibrillation in older people living in care homes in Wales: a routine data linkage study 2003-2018</title><author>Ritchie, Leona A ; Harrison, Stephanie L ; Penson, Peter E ; Akbari, Ashley ; Torabi, Fatemeh ; Hollinghurst, Joe ; Harris, Daniel ; Oke, Oluwakayode B ; Akpan, Asangaedem ; Halcox, Julian P ; Rodgers, Sarah E ; Lip, Gregory Y H ; Lane, Deirdre A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c390t-779ad8ceb3a1708e6d8ffb7b1d0a7e586eca64a756dccf090e1834e8efea54ba3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anticoagulants - adverse effects</topic><topic>Atrial Fibrillation - diagnosis</topic><topic>Atrial Fibrillation - epidemiology</topic><topic>Brain Ischemia</topic><topic>Humans</topic><topic>Information Storage and Retrieval</topic><topic>Prevalence</topic><topic>Research Paper</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Stroke - diagnosis</topic><topic>Stroke - epidemiology</topic><topic>Wales - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ritchie, Leona A</creatorcontrib><creatorcontrib>Harrison, Stephanie L</creatorcontrib><creatorcontrib>Penson, Peter E</creatorcontrib><creatorcontrib>Akbari, Ashley</creatorcontrib><creatorcontrib>Torabi, Fatemeh</creatorcontrib><creatorcontrib>Hollinghurst, Joe</creatorcontrib><creatorcontrib>Harris, Daniel</creatorcontrib><creatorcontrib>Oke, Oluwakayode B</creatorcontrib><creatorcontrib>Akpan, Asangaedem</creatorcontrib><creatorcontrib>Halcox, Julian P</creatorcontrib><creatorcontrib>Rodgers, Sarah E</creatorcontrib><creatorcontrib>Lip, Gregory Y H</creatorcontrib><creatorcontrib>Lane, Deirdre A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Age and ageing</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ritchie, Leona A</au><au>Harrison, Stephanie L</au><au>Penson, Peter E</au><au>Akbari, Ashley</au><au>Torabi, Fatemeh</au><au>Hollinghurst, Joe</au><au>Harris, Daniel</au><au>Oke, Oluwakayode B</au><au>Akpan, Asangaedem</au><au>Halcox, Julian P</au><au>Rodgers, Sarah E</au><au>Lip, Gregory Y H</au><au>Lane, Deirdre A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence and outcomes of atrial fibrillation in older people living in care homes in Wales: a routine data linkage study 2003-2018</atitle><jtitle>Age and ageing</jtitle><addtitle>Age Ageing</addtitle><date>2022-12-05</date><risdate>2022</risdate><volume>51</volume><issue>12</issue><issn>0002-0729</issn><eissn>1468-2834</eissn><abstract>To determine atrial fibrillation (AF) prevalence and temporal trends, and examine associations between AF and risk of adverse health outcomes in older care home residents.
Retrospective cohort study using anonymised linked data from the Secure Anonymised Information Linkage Databank on CARE home residents in Wales with AF (SAIL CARE-AF) between 2003 and 2018. Fine-Gray competing risk models were used to estimate the risk of health outcomes with mortality as a competing risk. Cox regression analyses were used to estimate the risk of mortality.
There were 86,602 older care home residents (median age 86.0 years [interquartile range 80.8-90.6]) who entered a care home between 2003 and 2018. When the pre-care home entry data extraction was standardised, the overall prevalence of AF was 17.4% (95% confidence interval 17.1-17.8) between 2010 and 2018. There was no significant change in the age- and sex-standardised prevalence of AF from 16.8% (15.9-17.9) in 2010 to 17.0% (16.1-18.0) in 2018. Residents with AF had a significantly higher risk of cardiovascular mortality (adjusted hazard ratio [HR] 1.27 [1.17-1.37], P < 0.001), all-cause mortality (adjusted HR 1.14 [1.11-1.17], P < 0.001), ischaemic stroke (adjusted sub-distribution HR 1.55 [1.36-1.76], P < 0.001) and cardiovascular hospitalisation (adjusted sub-distribution HR 1.28 [1.22-1.34], P < 0.001).
Older care home residents with AF have an increased risk of adverse health outcomes, even when higher mortality rates and other confounders are accounted for. This re-iterates the need for appropriate oral anticoagulant prescription and optimal management of cardiovascular co-morbidities, irrespective of frailty status and predicted life expectancy.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>36469091</pmid><doi>10.1093/ageing/afac252</doi><orcidid>https://orcid.org/0000-0001-6763-1489</orcidid><orcidid>https://orcid.org/0000-0002-8846-0946</orcidid><orcidid>https://orcid.org/0000-0002-0392-1767</orcidid><orcidid>https://orcid.org/0000-0002-3556-2017</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Age and ageing, 2022-12, Vol.51 (12) |
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| language | eng |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Aged Aged, 80 and over Anticoagulants - adverse effects Atrial Fibrillation - diagnosis Atrial Fibrillation - epidemiology Brain Ischemia Humans Information Storage and Retrieval Prevalence Research Paper Retrospective Studies Risk Factors Stroke - diagnosis Stroke - epidemiology Wales - epidemiology |
| title | Prevalence and outcomes of atrial fibrillation in older people living in care homes in Wales: a routine data linkage study 2003-2018 |
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