Admissions for Atrial Fibrillation in the Elderly Population: Evaluation of Demographic Predictors of Mortality From the National Inpatient Sample

Atrial fibrillation (AF) is the most common arrhythmia to affect elderly patients above 70 years of age and causes a significant burden. Multiple demographic factors have been linked to increased mortality in general in patients admitted with AF. The aim of our study is to delineate those factors in elderly patients admitted with atrial fibrillation in the United States. We used the Nationwide Inpatient Sample to evaluate the mortality of patients aged more than 70 admitted with AF between 2005 and 2014. We looked at variables such as race, sex, hospital location, hospital teaching status, hospital bed size, and hospital region to elucidate the association, if present, between those variables and mortality in our patient population. Specific ICD-9-CM codes were used to identify the study patients and their outcomes. Our results showed that 2,163,343 elderly patients above 70 years of age were admitted between 2005 and 2014, inclusive, with a diagnosis of AF. In those aged greater than 70, there was an association between sex and mortality (1.37% of females died vs. 1.48% of males died, p=0.004). However, patients who were white had a lower mortality rate than other races (1.38% of white patients died) at a p-value <0.0001. There was no correlation between hospital bed size or hospital teaching status (teaching vs. non-teaching) and mortality, with a p-value of 0.31 and 0.57, respectively. However, hospital location (1.39% mortality in urban vs. 1.51% in rural hospitals) and hospital region (the least mortality rate 1.24%, was found in Midwest and the highest, 1.58%, was found in Northeast), were associated with mortality, with corresponding p-values of 0.022 and <0.0001 respectively. The results of our analysis signify the need for further advancement of the hospital and regional-based resources. These outcomes reflect the gaps in the uniformity of nationwide medical care that the United States aims to attain.