METHODS: Consecutive attendances for AF in Victoria, Australia (January 2015-June 2019) were included if patients had a diagnosis of \"AF\" or \"arrhythmia\" with AF on electrocardiogram. Data were individually linked to emergency, hospital, and mortality records.
RESULTS: Of 2,613,056 EMS attendances, 16,525 were a first attendance for AF and linked to hospital records. Median (IQR) age was 76 (67,84) years (43% female). Seventy-eight percent had high thromboembolic risk (CHA2DS2-VASc score ≥ 2), and 72% had a heart rate ≥ 100 bpm. Forty-two percent of patients received no treatment by paramedics and 99.4% were transported to hospital. Fifty-three percent were discharged from ED. Median length of hospital stay was 2 days. Of 2542 cases reattended for AF, 19% occurred within 30 days, with increased odds for females and those of low socioeconomic status. Overall, 24% died during the study period, 12% within 30 days. Increasing age, heart failure, stroke, COPD, and low socioeconomic status increased the odds of 30-day mortality.
CONCLUSIONS: EMS utilisation for AF is common and associated with frequent reattendance. Further studies are required to investigate novel pathways of care to reduce AF burden on healthcare systems.
方法:在维多利亚州连续参加AF,澳大利亚(2015年1月至2019年6月)如果患者在心电图上诊断为“房颤”或“心律失常”伴房颤,则纳入研究。数据分别与紧急情况联系在一起,医院,和死亡率记录。
结果:在2,613,056名EMS出勤率中,16,525是房颤的首次就诊,并与医院记录相关联。年龄中位数(IQR)为76(67,84)岁(43%为女性)。78%的人有较高的血栓栓塞风险(CHA2DS2-VASc评分≥2),72%的患者心率≥100bpm.42%的患者没有接受护理人员的治疗,99.4%的患者被送往医院。53%从ED出院。平均住院时间为2天。在2542例房颤患者中,19%发生在30天内,女性和社会经济地位低的女性的几率增加。总的来说,24%在研究期间死亡,30天内12%。年龄增长,心力衰竭,中风,COPD,低社会经济地位增加了30天死亡率的几率.
结论:EMS用于房颤是常见的,并且与频繁的就诊相关。需要进一步的研究来研究新的护理途径,以减轻医疗保健系统的AF负担。