Adherence to Anti-coagulation Guidelines in Patients Presenting to the Emergency Department for Acute AF Management

Abstract

b) history of embolism (including stroke/TIA), (c) renal failure, (d) malignancy, (e) hemodynamic instability and (f) AF associated with another medical reason necessitating admission (e.g. underlying infection).Results: Seventy-one percent (n = 175) of patient presenting to the ED were admitted to hospital, with a consequent median length of stay of 2 [1-4] days. Older age (p = 0.01), clinical history of hypertension (p = 0.006) and out of hours presentation time (p = 0.02) were significant predictors of hospital admission, whilst the presence of diabetes mellitus (p = 0.10), impaired renal function (p = 0.08) and congestive heart failure (p = 0.16) trended toward predicting hospital admission. Nineteen percent of the patients admitted to hospital were considered to be low risk.Conclusion: Older age, out of hours presentation time and hypertension predicted hospitalisation for acute AF; however, ∼1 in 5 hospitalisations were for low risk patients. Treating a low risk patient in the ED could save ∼$2000 per presentation, which extrapolates to ∼13 million dollar saving Australia wide every year. http://dx.