Abstract 13524: A Global Comparison of Length of Hospital Stay Among Patients Presenting With Atrial Fibrillation in the Acute Care Setting: The RHYTHM-AF Study
Purpose: Length of stay (LoS) in hospital for atrial fibrillation (AF) can vary, though regional variations have not been well described. LoS of AF hospitalization across cardioversion therapies among presenting AF patients are compared.
Methods: RHYTHM-AF is a prospective observational study fielded in 10 countries. Patients considered for cardioversion were enrolled from hospital and acute care centers between May 2010 and April 2011. Data was collected at the time of AF, and descriptive statistics were used to compare LoS where available (in Australia (AUS), France, Germany (DEU), the Netherlands (NL), Poland, Spain, Sweden, and the UK). LoS was calculated as discharge minus admission time.
Results: Of 3397 patients, the median (med) LoS was 26 hrs (IQR 6-9). Approximately 70% underwent cardioversion: either pharmacologic (PCV, 35%), or electric (DCCV, 65%). On average, patients treated primarily with flecainide (35% of PCV) had the shortest LoS (med of 7 hrs (IQR 4-14 hrs), and those treated with amiodarone, the longest (med at 37 hrs) with widest variability (med IQR 15-145 hrs). Those who cardioverted had similar LoS compared to those who did not, though LoS varied substantially by region and therapy. The NL had a stable and short med LoS (5 hrs, IQR 4-7 hrs). Poland (69 hrs) and DEU (68 hrs) had the longest med LoS (IQR 27-119; IQR 26-150 hrs, respectively). LoS varied by region and mode of cardioversion. AUS (65% treated with DCCV), NL (77%), Sweden (96%) and the UK (85%) each had med LoS of under 24 hrs (13, 5, 6 and 7 hrs, respectively). Among those with DCCV (51%), the med LoS was highest in Poland (51% on DCCV) at 54 (IQR 46-77), in DEU (91% DCCV) at 53 (IQR 24-147), and in France (81% DCCV) at 46 (IQR 26-84) hrs. Among those on PCV, those in France (20%) and AUS (35%) had the highest med LoS at 203 (IQR 91-409) and 140 (IQR 47-242) hrs, respectively; the NL (23%) and Spain (79%), the lowest med LoS at 5 (IQR 3.5-8) and 16 (IQR 8-27) hrs.
Conclusions: There are substantial differences in LoS across countries. Findings may suggest that among those receiving the same treatment, there is variability in patients, physician practice patterns, or both. Further study as to how LoS may be associated with other health outcomes should be conducted to help minimize patient LoS and provider burden.
- © 2011 by American Heart Association, Inc.