Analysis of Patients Over 65 Years of Age Evaluated in the Emergency Department with the Diagnosis of Atrial Fibrillation

Year 2024, Volume: 7 Issue: 4, 172 - 177, 30.12.2024

Tabriz Haziyev , Şahin Aslan , Vahide Aslıhan Durak , Göksel Aydoğan

https://doi.org/10.54996/anatolianjem.1511879

Abstract

Aim: Atrial fibrillation (AF); is defined as a rapid and irregular contraction of the atria, characterized by arrhythmia in the heart. In general, AF cases are the most common among arrhythmias. The aim of our study is to examine the demographic characteristics of patients aged 65 and over who applied to the emergency department with the diagnosis of AF, as well as determining the underlying comorbidities and the treatments applied in the emergency department and to contribute to the data of our country.

Material and Methods: Our study was conducted retrospectively and single-centered to investigate the demographic characteristics of patients who applied to the emergency department between 01.01.2018 and 01.01.2023, who were newly diagnosed with AF and those who were previously diagnosed with AF (chronic) and to compare the obtained data.

Results: Of the 335 patients included in the study, 200 (59.7%) were female and 135 (40.7%) were male. 110 patients were between 65-74 (32.8%), 136 patients were between 75-84 (40.6%), and 89 patients were between 85+ (26.6%) years of age. The most common complaints for emergency department admission were palpitations, dyspnea, chest pain, and syncope. While 9 (2.7%) of the patients had newly diagnosed AF, 326 (97.3%) were categorized as chronic AF. The most common diseases among risk factors were hypertension, heart failure, coronary artery disease, chronic renal failure, and diabetes. While 231 (69%) patients did not smoke, 102 (30.4%) patients were chronic users, and 2 (0.6%) patients were former smokers. While 203 (60.6%) of the patients were discharged, 43 (12.8%) were admitted to the intensive care unit, the majority of the remaining patients were admitted to different clinics, and 3 (0.9%) patients were accepted as exitus in the emergency department.

Conclusion: It is thought that our study will shed light on and contribute to the approaches of emergency physicians in the management of risk factors, possible clinical conditions and coronary syndromes requiring treatment in patients admitted to the emergency department with atrial fibrillation diagnosis.

Keywords

Emergency department, atrial fibrillation, acute coronary syndrome

Ethical Statement

Bursa Uludağ Üniversitesi Tıp Fakültesi Klinik Araştırmalar Etik Kurulu 2023- 3/45

Supporting Institution

bulunmamaktadır

Thanks

-

Atriyal Fibrilasyon Tanısı ile Acil Serviste Değerlendirilen 65 Yaş Üzeri Hastaların Analizi

Abstract

Amaç: Atriyal fibrilasyon (AF); kalpte ritim bozukluğu ile karakterize edilen, atriyumların hızlı ve düzensiz bir biçimde kasılma hareketi göstermesi olarak tanımlanmaktadır. Genel olarak ritim bozuklukları arasında en çok AF’li vakalar görülmektedir. Çalışmamızın amacı acil servise AF tanısı ile başvuran 65 yaş ve üzeri hastaların demografik özelliklerini, altta yatan ek hastalıkları ve acil serviste uygulanılan tedavileri incelemek ve ülkemiz verilerine katkıda bulunmaktır.

Gereç ve Yöntem: Çalışmamız 01.01.2018 – 01.01.2023 tarihleri arasında acil servise başvuran, yeni AF tanısı alan ve daha önce AF tanısı almış (kronik) hastaların demografik özelliklerini araştırmak ve elde edilen verileri karşılaştırmak amacıyla retrospektif ve tek merkezli olarak yapılmıştır.

Bulgular: Çalışmaya dahil edilen 335 hastanın 200 (%59,7)’ü kadın, 135 (%40,7)’i ise erkek idi. 110 hasta 65-74 (%32,8), 136 hasta 75-84 (%40,6), 89 hasta 85+ (%26,6) yaş aralığındaydı. Acil servise en sık başvuru şikayetleri çarpıntı, dispne, göğüs ağrısı, senkop şeklinde belirlendi. Hastaların 9 (%2,7)’unda yeni tanı AF iken 326 (%97,3)’sı ise kronik AF olarak kategorize edildi. Risk faktörleri arasında en sık görülen hastalıklar hipertansiyon, kalp yetmezliği, koroner arter hastalığı, kronik böbrek yetmezliği ve diabet olarak izlendi. 231 (%69) hastada sigara kullanımı yok iken, 102 (%30,4) hasta kronik kullanıcı, 2 (%0,6) hasta ise sigarayı bırakmış olarak belirlendi. Hastalardan 203 (%60,6)’ü taburcu olurken, 43 (%12,8) hasta yoğun bakıma, geriye kalan hastaların büyük çoğunluğu farklı kliniklere yatırıldı, 3 (%0,9) hasta ise acil serviste exitus olarak kabul edildi.

Sonuç: Çalışmamızın acil servise atriyal fibrilasyon tanısı ile başvuran hastalarda risk faktörleri, karşılaşılabilecek klinik durumlar ve tedavi gerektiren koroner sendromların yönetiminde acil servis hekimlerinin yaklaşımlarına ışık tutacağı ve katkı sağlayacağı düşünülmüştür.

Keywords

Acil servis, atriyal fibrilasyon, akut koroner sendrom, akut koroner sendrom

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