Prevalence of atrial fibrillation, oral anticoagulation prescription and associated factors in Brazilian older adults
Geriatrics, Gerontology and Aging
Prevalence of atrial fibrillation, oral anticoagulation prescription and associated factors in Brazilian older adults
Autor Correspondente: Vitor Pelegrim de Oliveira | [email protected]
Palavras-chave: atrial fibrillation; anticoagulants; prevalence; geriatrics; cerebral infarction.
Resumos Cadastrados
Resumo Inglês:
INTRODUCTION: Atrial fibrillation increases five times the risk of stroke. Anticoagulation reduces the incidence of cerebrovascular events. However, many patients do not receive thromboprophylaxis.
OBJECTIVES: To estimate the prevalence of atrial fibrillation in the older patients at a Brazilian university hospital and the proportion of anticoagulation prescription. Secondary objectives were to identify the therapeutic options, the main reasons for non-prescription and the factors associated with ineffectiveness or lack of treatment.
METHODS: This was a cross-sectional study with a consecutive sample of 1,630 outpatients selected at Hospital de Clínicas de Porto Alegre between April and June of 2017. Atrial fibrillation was identified in 220 (13.50%) individuals. t Medical records from 145 patients were accessed, followed by a telephone interview. The association between variables and “ outcomes was checked using the Mann-Whitney’s U Test and a chi-squared test.
RESULTS: The prevalence of atrial fibrillation was 13.50%. Anticoagulation therapy was prescribed in 77.93% of cases. In 76.11% of patients, warfarin was the chosen drug. < There was a tendency towards no prescription in patients with previous bleeding (RR = 2.32; 95%CI 0.95 - 5.64; p = 0.06) and falls (RR = 2.02; 95%CI 0.82 - 5.03; p = 0.08). We found an association between reduced functional capacity (Barthel’s Activities of Daily Living Score < 80) and higher rate of anticoagulation in therapeutic target (RR = 0.22; 95%CI 0.06 - 0.87; p = 0.04).
CONCLUSION: The prevalence of atrial fibrillation in this population was 13.50% and in 77.93% of cases anticoagulant were prescribed. Functional impairment was associated with a higher rate of anticoagulation in therapeutic target.
