Objective: Few data are available about patients with stroke and atrial fibrillation (AF) in Australia. We sought to describe outcomes for people with AF admitted to hospital with acute stroke.
Methods: Data were collected by retrospective clinical audit on consecutive patients with acute stroke admitted to public hospitals in 2008. Patients with known AF status (pre-stroke/new onset) were included. Patient characteristics, stroke subtype, modified Rankin Score (mRS), living arrangements and antithrombotic medication (pre- and post-stroke) were documented. Multivariable logistic regression adjusting for age, co-morbidity, stroke type, stroke severity variables and patient clustering for health outcome assessments were undertaken.
Results: AF status was known for 2,707 (92%) cases; 974 had pre-stroke/new onset AF. More patients with AF (36%) had a history of stroke/TIA when compared to those without AF (29%) (p <0.001). The median age at stroke onset was greater in those with AF (81 years [IQR 75-86] v no AF 74 years [IQR 62-82]). Few (30%) AF cases with ischaemic stroke were on warfarin prior to stroke onset and 42% of AF cases with ischaemic stroke were discharged on warfarin. Stroke survivors with AF had a 1.56 greater odds (95% CI 1.14 to 2.12) of being discharged to aged care and 1.48 greater odds of dying in hospital (95%CI 1.08 to 2.03) than patients without AF.
Conclusion: People with stroke that have AF experience worse health outcomes. Considering the cost of AF to the health system (about $1.25 billion), more research and use of evidence-based treatment is needed.