PREVALENCE OF ATRIAL FIBRILLATION, ORAL ANTICOAGULATION PRESCRIPTION AND ASSOCIATED FACTORS IN BRAZILIAN OLDER ADULTS

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 uni...

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Main Authors: Vitor Pelegrim de Oliveira, Renato Gorga Bandeira de Mello, Andry Fiterman Costa, Roberta Rigo Dalla Corte, Francine da Rocha Flores, Nicóli Bertuol Xavier, Nathália Marzotto Nunes, Emilio Hideyuki Moriguchi
Format: Article
Language:English
Published: Brazilian Society of Geriatrics and Gerontology 2021-02-01
Series:Geriatrics, Gerontology and Aging
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Online Access:https://ggaging.com/details/1652/en-US/prevalence-of-atrial-fibrillation--oral-anticoagulation-prescription-and-associated-factors-in-brazilian-older-adults
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Summary: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. 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.
ISSN:2447-2123