Adequacy of ESC atrial fibrillation guidelines in the elderly population: Analysis of practices from an internal medicine department - 10/02/16
Abstract |
Background |
Atrial fibrillation (AF) is a particularly prevalent and challenging to manage disease in the elderly. This study aims to evaluate the adequacy of ESC guidelines for the management of AF in a clinical setting with an aged population.
Methods |
Retrospective study of 212 hospitalizations with a diagnosis of AF. Patients admitted to the unit from January to June of 2012 were eligible for the study; their clinical status, underlying morbidities, and AF treatments were assessed.
Results |
The mean age of the study population was 78.6±10.2 years old; more than 90% of the cases were≥65 years old. Permanent AF was the most frequent form of the disease (66.0%), followed by paroxysmal AF (24.1%). Infection was the leading reason for hospitalization (39.2% of cases); AF (or flutter) was the reason for hospitalization in 15.6% of cases. Rate and/or rhythm control therapy was administered in 40.6% of cases at the emergency department and in 75.0% of cases at discharge; amiodarone was the most used drug in all clinical scenarios. At admission, anticoagulation therapy was not being used in 64.1% of cases; at discharge (57.2%). The main reason for non-anticoagulation was HAS-BLED≥3 (60%); in 23.5% of the cases there was no explicit reason for non-anticoagulation.
Conclusion |
The elderly population with AF presents some distinctive characteristics that the current ESC guidelines do not consistently address. There is a need to develop guidelines tailored to the elderly population, allowing the use of validated, systematic treatment approaches in this highly relevant population.
Le texte complet de cet article est disponible en PDF.Keywords : Atrial fibrillation, Elderly, ESC guideline, Rate control therapy, Rhythm control therapy
Plan
Vol 7 - N° 1
P. 23-27 - février 2016 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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