Seasonal Variation of Atrial Fibrillation Admission and Quality of Care in the United States.
Seasonal Variation of Atrial Fibrillation Admission and Quality of Care in the United States.
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DOI：
10.1161/jaha.121.023110
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发表时间：
2022-02-15
影响因子：
5.4
通讯作者：
Bhatt, Deepak L.
中科院分区：
文献类型：
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作者：
Sheehy, Shanshan;Fonarow, Gregg C.;Holmes, DaJuanicia N.;Lewis, William R.;Matsouaka, Roland A.;Piccini, Jonathan P.;Zhi, Lillian;Bhatt, Deepak L.
目前，关于美国房颤（AF）的季节性变化以及AF的护理质量是否在季节之间变化知之甚少。GWTG‐AFib（遵循指南-AFib）登记研究由美国心脏协会发起，旨在加强AF治疗和管理的国家指南依从性。我们的分析包括2014年至2018年美国141家参与医院收治的61291例患者。结局包括房颤入院人数和护理质量指标（无缺陷护理，定义为患者接受所有合格指标）。对于护理质量指标，使用解释研究中心内相关性的广义估计方程估计比值比（OR）和95% CI，调整患者和医院特征。每个季节的AF入院比例相似，秋季的AF入院比例最高（春季25%，夏季25%，秋季27%，冬季24%）。总体而言，各季节的房颤入院率相似，未观察到季节性变化。未观察到AF事件的季节性变化。护理质量无季节性差异（与春季相比，冬季多变量调整OR和95% CI为0.93（0.87-1.00），夏季为1.09（1.01-1.18），秋季为1.08（0.97-1.20））。在一项全国性的质量改善登记研究中，未观察到房颤住院或房颤护理质量的季节性变化。
Currently, little is known regarding seasonal variation for atrial fibrillation (AF) in the United States and whether quality of care for AF varies between seasons. The GWTG‐AFib (Get With The Guidelines–AFib) registry was initiated by the American Heart Association to enhance national guideline adherence for treatment and management of AF. Our analyses included 61 291 patients who were admitted at 141 participating hospitals from 2014 to 2018 across the United States. Outcomes included numbers of AF admissions and quality‐of‐care measures (defect‐free care, defined as a patient’s receiving all eligible measures). For quality‐of‐care measures, generalized estimating equations accounting for within‐site correlations were used to estimate odds ratios (ORs) with 95% CIs, adjusting patient and hospital characteristics. The proportion of AF admissions for each season was similar, with the highest percentage of AF admissions being observed in the fall (spring 25%, summer 25%, fall 27%, and winter 24%). Overall, AF admissions across seasons were similar, with no seasonal variation observed. No seasonal variation was observed for incident AF. There were no seasonal differences in care quality (multivariable adjusted ORs and 95% CIs were 0.93 (0.87–1.00) for winter, 1.09 (1.01–1.18) for summer, and 1.08 (0.97–1.20) for fall, compared with spring). In a nationwide quality improvement registry, no seasonal variation was observed in hospital admissions for AF or quality of care for AF.