Mortality and causes of death in patients with atrial fibrillation: A nationwide population-based study
Mortality and causes of death in patients with atrial fibrillation: A nationwide population-based study
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DOI：
10.1371/journal.pone.0209687
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发表时间：
2018-12-26
期刊：
影响因子：
3.7
通讯作者：
Oh, Seil
中科院分区：
文献类型：
--
作者：
Lee, Euijae;Choi, Eue-Keun;Oh, Seil
研究背景众所周知，房颤患者的死亡率很高。关于房颤对死亡风险的影响，按年龄、性别和详细死因分层的人群研究很少。方法从韩国国家医疗保险服务-国家样本队列中登记15,411例房颤患者，并根据国际疾病分类第10次修订的编码确定死因。结果2002年至2013年，共确诊4,479例(29%)死亡，全原因死亡的粗死亡率为63.3/1000患者年。与普通人群相比，房颤患者全因死亡的风险增加了3.7倍。全死因死亡标化比在年轻患者中最高，并随年龄增长而下降(标化死亡比21.93，80岁患者标化死亡率95%可信区间7.60-26.26)。女性房颤患者的超额死亡风险高于男性(女性标化死亡率比3.81，95%可信区间3.65-3.98；男性标化死亡率比3.35，95%可信区间3.21-3.48)。心血管疾病是主要死因(38.5%)，脑梗塞是最常见的特殊疾病。房颤患者死于心血管疾病的风险是普通人群的5倍。结论房颤患者的死亡风险是普通人群的4倍。然而，心房颤动对死亡率的影响随着年龄和男性的增加而降低。脑梗塞是最常见的死亡原因，应更多地关注降低中风的风险。
BackgroundPatients with atrial fibrillation are known to have a high risk of mortality. There is a paucity of population-based studies about the impact of atrial fibrillation on the mortality risk stratified by age, sex, and detailed causes of death.MethodsA total of 15,411 patients with atrial fibrillation from the Korean National Health Insurance Service-National Sample Cohort were enrolled, and causes of death were identified according to codes of the 10th revision of the International Classification of Diseases.ResultsFrom 2002 to 2013, a total of 4,479 (29%) deaths were confirmed, and the crude mortality rate for all-cause death was 63.3 per 1,000 patient-years. Patients with atrial fibrillation had a 3.7-fold increased risk of all-cause death compared with the general population. The standardized mortality ratio for all-cause death was the highest in young patients and decreased with increasing age (standardized mortality ratio 21.93, 95% confidence interval 7.60-26.26 in patients aged = 80 years). Women with atrial fibrillation exhibited a greater excess mortality risk than men (standardized mortality ratio 3.81, 95% confidence interval 3.65-3.98 in women; standardized mortality ratio 3.35, 95% confidence interval 3.21-3.48 in men). Cardiovascular disease was the leading cause of death (38.5%), and cerebral infarction was the most common specific disease. Patients with atrial fibrillation had an about 5 times increased risk of death due to cardiovascular disease compared with the general population.ConclusionsPatients with atrial fibrillation had a 4 times increased risk of mortality compared with the general population. However, the impact of atrial fibrillation on mortality decreased with age and in men. Cerebral infarction was the most common cause of death, and more attention should be paid to reducing the risk of stroke.