Abstract 12541: Features and Causes of Death of Patients With Atrial Fibrillation Seen in French Hospitals in 2012
Introduction/Hypothesis: Atrial fibrillation (AF) has been associated with worse clinical outcomes in many cardiovascular (CV) disease states. There is a lack of data on real world specific causes of deaths in AF patients. The objective of this study was to provide features and causes of deaths of patients with AF seen in French hospitals.
Methods: This French cohort study was based on the national hospitalization database (PMSI) covering hospital care for the entire population. All discharged dead patients in 2012 with a previous diagnosis of AF were identified. Cause of death was defined as the principal diagnosis of the last hospitalization stay. Thromboembolic risk scores (HAS-BLED, HEMORR2HAGES and ATRIA) and bleeding risk scores (CHADS2 and CHA2DS2-VASc) calculations were based on a 5-year look-back period of medical history.
Results: In 2012, 533,044 AF patients were identified through the PMSI; among them 50,165 (9.4%) died in French hospitals. Deceased patients were older than patients discharged alive (82.3±9.3 vs. 78.0±11.4; p<0.001). They more often suffered from hypertension (73% vs. 70%), diabetes (27% vs. 24%), renal failure (39% vs. 23%), cancer (30% vs. 19%) and, liver failure (9% vs. 5%) (p<0.001 in all cases). Mean stroke and bleeding risk scores were significantly higher for dead patients: CHADS2 was 2.7±1.3 vs. 2.3±1.3 (p<0.001), CHA2DS2-VASc was 4.6±1.6 vs. 4.0±1.8 (p<0.001), HAS-BLED was 2.6±1.1 vs. 2.2±1.1 (p<0.001), HEMORR2HAGES was 3.0±1.4 vs. 2.3±1.5 (p<0.001) and ATRIA was 4.4±2.4 vs. 3.3±2.4 (p<0.001). Cardiovascular (CV)-related deaths represented 34% of all deaths, including heart failures (15.0%), strokes (8.5%), hemorrhages (1.4%) and, TIA/Systemic embolism (1.3%) (cf. Table1).
Conclusions: In this systematic analysis of a real-life contemporary AF population, about 10% of deaths were related to stroke/TIA/SE. Despite CV events were a major cause of deaths; a greater part of deaths was related to non-CV causes.
Author Disclosures: L. Fauchier: Honoraria; Modest; Bristol-Myers Squibb / Pfizer. A. Samson: Employment; Significant; Bristol-Myers Squibb. G. Chaize: Consultant/Advisory Board; Modest; Bristol-Myers Squibb / Pfizer. A. Gaudin: Employment; Significant; Bristol-Myers Squibb. A. Vainchtock: Consultant/Advisory Board; Modest; Bristol-Myers Squibb / Pfizer. C. Bailly: Employment; Significant; Bristol-Myers Squibb. F. Cotté: Employment; Significant; Bristol-Myers Squibb.
- © 2014 by American Heart Association, Inc.