TY - JOUR
T1 - FACTORS ASSOCIATED WITH ANTICOAGULATION INITIATION FOR NEW ATRIAL FIBRILLATION IN AN URBAN EMERGENCY DEPARTMENT
AU - Seiden, Johanna
AU - Lessen, Samantha
AU - Cheng, Natalie T.
AU - Friedman, Benjamin W.
AU - Labovitz, Daniel L.
AU - Esenwa, Charles C.
AU - Liberman, Ava L.
N1 - Publisher Copyright:
© 2022 Ethnicity and Disease, Inc.. All rights reserved.
PY - 2022
Y1 - 2022
N2 - Objective: To explore factors associated with anticoagulation (AC) initiation after atrial fibrillation (AF) diagnosis. Design: Retrospective cohort study. Setting: Urban medical center. Patients: Adults with emergency department (ED) diagnosis of new onset AF from 1/1/2017-1/1/2020 discharged home. Methods: We compared patients initiated on AC, our primary outcome, to those not initiated on AC. Stroke, major bleeding, and AC initiation within 1 year of visit were secondary outcomes. We hypothesized that minority race and non-English language preference are associated with failure to initiate AC. Results: Of 111 patients with AF, 88 met inclusion criteria. Mean age was 65 (SD 15); 47 (53%) were women. 49 (56%) patients were initiated on AC. Age (61 vs 68 years; P=.02), non-English language (28% vs 10%; P=.03), leaving ED against medical advice (AMA) (36% vs 14%; P=.04), and CHA2DS2VASc score of 1 (41% vs 6%; P<=.001) were associated with no AC initiation. There were no associations between patient-reported race/ethnicity and AC. Cardiology consultation (83.67% vs 30.78%; P<.0001) and higher median CHA2DS2-VASc score (3[2-4]) vs. 2[1-4]; P=.047) were associated with AC. Of 73 patients with follow-up data at 1 year, 2 (8%) not initiated on AC had strokes, 2 (4%) initiated on AC had major bleeds, and 15 (62.5%) not initiated on AC in the ED subsequently were initiated on AC. Conclusion: More than half of ED patients with new AF eligible for AC were initiated on it.
AB - Objective: To explore factors associated with anticoagulation (AC) initiation after atrial fibrillation (AF) diagnosis. Design: Retrospective cohort study. Setting: Urban medical center. Patients: Adults with emergency department (ED) diagnosis of new onset AF from 1/1/2017-1/1/2020 discharged home. Methods: We compared patients initiated on AC, our primary outcome, to those not initiated on AC. Stroke, major bleeding, and AC initiation within 1 year of visit were secondary outcomes. We hypothesized that minority race and non-English language preference are associated with failure to initiate AC. Results: Of 111 patients with AF, 88 met inclusion criteria. Mean age was 65 (SD 15); 47 (53%) were women. 49 (56%) patients were initiated on AC. Age (61 vs 68 years; P=.02), non-English language (28% vs 10%; P=.03), leaving ED against medical advice (AMA) (36% vs 14%; P=.04), and CHA2DS2VASc score of 1 (41% vs 6%; P<=.001) were associated with no AC initiation. There were no associations between patient-reported race/ethnicity and AC. Cardiology consultation (83.67% vs 30.78%; P<.0001) and higher median CHA2DS2-VASc score (3[2-4]) vs. 2[1-4]; P=.047) were associated with AC. Of 73 patients with follow-up data at 1 year, 2 (8%) not initiated on AC had strokes, 2 (4%) initiated on AC had major bleeds, and 15 (62.5%) not initiated on AC in the ED subsequently were initiated on AC. Conclusion: More than half of ED patients with new AF eligible for AC were initiated on it.
KW - Anticoagulation
KW - Atrial Fibrillation
KW - Emergency Medicine
KW - Stroke Prevention
UR - http://www.scopus.com/inward/record.url?scp=85142201077&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85142201077&partnerID=8YFLogxK
U2 - 10.18865/ed.32.4.325
DO - 10.18865/ed.32.4.325
M3 - Article
C2 - 36388863
AN - SCOPUS:85142201077
SN - 1049-510X
VL - 32
SP - 325
EP - 332
JO - Ethnicity and Disease
JF - Ethnicity and Disease
IS - 4
ER -