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Inicio Medicina Clínica (English Edition) Temporal evolution of treatment of patients with atrial fibrillation in a urban ...
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Vol. 144. Issue 11.
Pages 483-486 (June 2015)
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Vol. 144. Issue 11.
Pages 483-486 (June 2015)
Original article
Temporal evolution of treatment of patients with atrial fibrillation in a urban health care area
Evolución temporal del tratamiento de los pacientes con fibrilación auricular en un área sanitaria urbana
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Carolina Fuenzalidaa,b,c,
Corresponding author
carofuenzali@gmail.com

Corresponding author.
, Blanca Coll-Vinenta,b,c, Marta Navarroa,d,e, Álvaro Cerveraa,f, Miguel Camaforta,g, Lluís Monta,h, on behalf of the Atrial Fibrillation Unit (UFA), Hospital Clínic de Barcelona
a Unitat de Fibrillació Auricular (UFA), Hospital Clínic, Barcelona, Spain
b Àrea d’Urgències, Hospital Clínic, Barcelona, Spain
c Grup de recerca «Urgències: processos i patologies», Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
d Centre d’Atenció Primària Borrell, Barcelona, Spain
e Grup Transversal d’Investigació en Atenció Primària, IDIBAPS, Barcelona, Spain
f Unitat d’Ictus, Hospital Clínic, Barcelona, Spain
g Servei de Medicina Interna, Hospital Clínic, Barcelona, Spain
h Unitat d’Arítmies, Servei de Cardiologia, Hospital Clínic, Barcelona, Spain
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Table 1. Clinical characteristics of the patients included. Epidemiological differences exist between the different areas of inclusion.
Abstract
Background and objective

To evaluate the adequacy of atrial fibrillation (AF) management 6 years after the establishment of a coordinated AF unit.

Patients and methods

Patients with AF attended during 14 consecutive days in the Emergency Room, Internal Medicine, Neurology and Arrhythmia departments of a tertiary hospital, and 3 primary healthcare centres of the same urban health care area were included. Treatment for AF and its adequacy to current clinical guidelines, tests performed and knowledge about the arrhythmia were evaluated. Results were compared with a population of 239 patients treated 6 years earlier.

Results

One hundred and sixty-eight patients were included. Knowledge of the arrhythmia improved. The adequacy of treatment (rate control, rhythm control and antithrombotic prophylaxis) remained at the same level as in the previous period in all areas. The adequacy of thromboprophylaxis was negatively associated with advanced age (p<0.001) and positively associated with knowledge of arrhythmia (p=0.026).

Conclusion

Treatment of AF in a coordinated health area remains appropriate 6 years after the establishment of a coordinated AF unit. Elderly patients are still poorly anticoagulated. Health education may improve this deficit.

Keywords:
Atrial fibrillation
Treatment
Health care levels
Resumen
Fundamento y objetivo

Evaluar la adecuación del tratamiento de la fibrilación auricular (FA) 6 años después de la instauración de una Unidad coordinada de FA.

Pacientes y me¿todos

Pacientes con FA atendidos durante 14 días consecutivos en los servicios de Urgencias, Medicina Interna, Neurología y Arritmias de un hospital de tercer nivel y en 3 centros de atención primaria de un área sanitaria. Se evaluó tratamiento y adecuación a las guías clínicas vigentes, pruebas realizadas y conocimiento de la arritmia. Se compararon los resultados con los de una población de 239 pacientes atendidos 6 años antes.

Resultados

Se incluyeron 168 pacientes. Mejoró el conocimiento de la arritmia. La adecuación deltratamiento (control de frecuencia, control de ritmo y profilaxis antitrombótica) se mantuvo. La adecuación de la profilaxis antitrombótica se asoció negativamente con la edad avanzada (p<0,001) y positivamente con el conocimiento de la arritmia (p=0,026).

Conclusión

El tratamiento de la FA en un área sanitaria coordinada se mantiene adecuado 6 años después de la instauración de una Unidad coordinada de FA. Los pacientes de edad avanzada todavía son poco anticoagulados. La educación sanitaria puede mejorar este déficit.

Palabras clave:
Fibrilación auricular
Tratamiento
Niveles asistenciales

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