Atrial fibrillation in a multiethnic inpatient population of a large public hospital.

INTRODUCTION

Atrial fibrillation (AF) has not been well-studied in minority and underserved populations. We report a one-year inpatient experience of AF among 80,021 total ECG records in a multiethnic population of a large public hospital.

METHODS

ECG parameters, demographic data, discharge diagnoses, and discharge status were compiled for the first 1,999 hospitalizations associated with AF among 80,021 total ECG records and compared among the population subgroups.

RESULTS

Of 3,935 records of patients with AF, 737 matched first hospitalizations. Mean age was 62.3 years; 56% were male. Hispanics comprised 59.2%, Caucasians 16.4%, Asians 11.1%, African Americans 10.3%; unclassified 3%; 30.6% were uninsured. Compared to Caucasians, Left ventricular hypertrophy was more common in African-American [9.9% vs. 21.1%, odds ratio (OR)=2.3] and Asians (9.9% vs. 15.3%, OR=2.76). At discharge, Caucasians more frequently had coronary artery disease, compared to Hispanics (26.4% vs. 17.7%, OR=0.62), African Americans (26.4% vs. 10.5%, OR=0.36), and Asians (26.4% vs. 8.5%, OR=0.25); cardiomyopathy was less common in Caucasians as compared to African Americans (2.5% vs. 10.5%, OR=4.2), Hispanics (2.5% vs. 3.9%, OR=1.5) and Asians (2.5% vs. 4.9%, OR=1.96). Mortality was 16%; nonsurvivors compared to survivors were older, 64.9 years vs. 61.8 years, p<0.05, more frequently had myocardial infarction (20.4% vs. 6.2%, p=0.000) and stroke (16.5% vs. 5.0%, p=0.000).

CONCLUSIONS

This AF population, particularly African Americans, was younger than previously reported. ECG and discharge parameters had differential frequencies among race/ethnic subgroups. Nonsurvivors were older and more commonly had myocardial infarction and stroke. Further study is warranted of AF occurrence, management, and outcomes in lower-socioeconomic, multiethnic populations.