Abstract 15385: Re-hospitalization Rates Following Stroke and Major Bleeding in Nonvalvular Atrial Fibrillation Patients
OBJECTIVES: Although prior studies have documented re-hospitalization outcomes after stroke among patients with atrial fibrillation (AF), there are limited data regarding subsequent outcomes following major bleeding (MB). We sought to determine overall rates of hospitalizations for stroke and MB and to estimate re-hospitalization rates following each type of event in a real-world nonvalvular atrial fibrillation (NVAF) population.
METHODS: A retrospective claims analysis of patients with NVAF enrolled in U.S commercial and Medicare health plans during 2008-2012 was performed. Thirty day and 1-year rates of all-cause, stroke related, and MB related re-hospitalizations were calculated separately for patients surviving a stroke and for those surviving MB. Overall rates were calculated by counting both initial and subsequent admissions. Re-hospitalization rates were calculated by counting all readmissions.
RESULTS: Fifty-three percent of 40,654 patients included in the study received an anticoagulant. The overall rate of hospitalizations for major bleeding excluding intracranial hemorrhage (MBEIH) was higher compared to the overall rate of hospitalizations for stroke (13.4 vs. 9.3 per 100 PY) (TABLE). Among 5,512 patients with stroke, more than half (52%) were re-hospitalized during the first year after discharge. Among those with MB (n=8,452), 54% were re-hospitalized during the first year. Twenty-two percent of all-cause re-hospitalizations were related to stroke and 18% were related to MB during the first year following initial stroke. During the first year following first MB, 10% of all-cause re-hospitalizations were related to stroke and 25% were related to MB.
CONCLUSIONS: Patients with NVAF face a significant risk of re-hospitalization following both stroke and MB events. Interventions preventing these events have the potential to reduce the large burden associated with re-hospitalization.
Author Disclosures: G.V. Naccarelli: Speakers Bureau; Significant; Pfizer, Bristol Myers Squibb, Janssen, Boehringer-Ingelheim. Consultant/Advisory Board; Modest; Otsuka, Xention. Consultant/Advisory Board; Significant; Glaxo-Smith-Kline, Pfizer, Sanofi, Bristol Myers Squibb, Janssen, Daiichi-Sankyo, Boehringer-Ingelheim. M. Stokes: Employment; Modest; Evidera. R. Wang: Employment; Modest; Evidera. A. DeLeon: Employment; Significant; Bristol-Myers Squibb. Ownership Interest; Modest; Bristol-Myers Squibb. N.A. Tate: Employment; Significant; Bristol-Myers Squibb. A. Wang: Employment; Modest; Evidera. J.R. Fredell: None.
- © 2014 by American Heart Association, Inc.