Jurnal internasional Afrika vol.11 issue 4 2021
African Journal of Emergency Medicine
The prevalence, management, and thirty-day outcomes of symptomatic atrial fibrillation in a Tanzanian emergency department
Dublin Core
Title
Jurnal internasional Afrika vol.11 issue 4 2021
African Journal of Emergency Medicine
The prevalence, management, and thirty-day outcomes of symptomatic atrial fibrillation in a Tanzanian emergency department
African Journal of Emergency Medicine
The prevalence, management, and thirty-day outcomes of symptomatic atrial fibrillation in a Tanzanian emergency department
Subject
Atrial fibrillation
Tanzania
Emergency Centre
Sub-Saharan Africa
Tanzania
Emergency Centre
Sub-Saharan Africa
Description
Introduction: Data describing atrial fibrillation (AF) care in emergency centres (ECs) in sub-Saharan Africa is
lacking. We sought to describe the prevalence and outcomes of AF in a Tanzanian EC.
Methods: In a prospective, observational study, adults presenting with chest pain or shortness of breath to a
Tanzanian EC were enrolled from January through October 2019. Participants underwent electrocardiogram
testing which were reviewed by two independent physician judges to determine presence of AF. Participants
were asked about their medical history and medication use at enrollment, and a follow-up questionnaire was
administered via telephone thirty days later to assess mortality, interim stroke, and medication use.
Results: Of 681 enrolled patients, 53 (7.8%) had AF. The mean age of participants with AF was 68.1, with a
standard deviation (sd) of 21.1 years, and 23 of the 53 (43.4%) being male. On presentation, none of the par-
ticipants found to have AF reported a previous history of AF. The median CHADS-VASC score among participants
was 4 with an interquartile range (IQR) of 2-4. No participants were taking an anticoagulant at baseline. On
index presentation, 49 (92.5%) participants with AF were hospitalised with 52 (98.1%) participants completing
30-day follow-up. 18 (34%) participants died, and 5 (9.6%) suffered a stroke. Of the surviving 31 participants
with AF and a CHADS-VASC score ≥ 2, none were taking other anti-coagulants at 30 days. Compared to par-
ticipants without AF, participants with AF were more likely to be hospitalised (OR 5.25, 95% CI 2.10-17.95, p <
0.001), more likely to die within thirty days (OR 1.93, 95% CI 1.03-3.50, p = 0.031), and more likely to suffer a
stroke within thirty days (OR 5.91, 95% CI 1.76-17.28, p < 0.001).
Discussion: AF is common in a Tanzanian EC, with thirty-day mortality being high, but use of evidence-based
therapies is rare. There is an opportunity to improve AF care and outcomes in Tanzania.
lacking. We sought to describe the prevalence and outcomes of AF in a Tanzanian EC.
Methods: In a prospective, observational study, adults presenting with chest pain or shortness of breath to a
Tanzanian EC were enrolled from January through October 2019. Participants underwent electrocardiogram
testing which were reviewed by two independent physician judges to determine presence of AF. Participants
were asked about their medical history and medication use at enrollment, and a follow-up questionnaire was
administered via telephone thirty days later to assess mortality, interim stroke, and medication use.
Results: Of 681 enrolled patients, 53 (7.8%) had AF. The mean age of participants with AF was 68.1, with a
standard deviation (sd) of 21.1 years, and 23 of the 53 (43.4%) being male. On presentation, none of the par-
ticipants found to have AF reported a previous history of AF. The median CHADS-VASC score among participants
was 4 with an interquartile range (IQR) of 2-4. No participants were taking an anticoagulant at baseline. On
index presentation, 49 (92.5%) participants with AF were hospitalised with 52 (98.1%) participants completing
30-day follow-up. 18 (34%) participants died, and 5 (9.6%) suffered a stroke. Of the surviving 31 participants
with AF and a CHADS-VASC score ≥ 2, none were taking other anti-coagulants at 30 days. Compared to par-
ticipants without AF, participants with AF were more likely to be hospitalised (OR 5.25, 95% CI 2.10-17.95, p <
0.001), more likely to die within thirty days (OR 1.93, 95% CI 1.03-3.50, p = 0.031), and more likely to suffer a
stroke within thirty days (OR 5.91, 95% CI 1.76-17.28, p < 0.001).
Discussion: AF is common in a Tanzanian EC, with thirty-day mortality being high, but use of evidence-based
therapies is rare. There is an opportunity to improve AF care and outcomes in Tanzania.
Creator
Isaac O. Oyediran , Sainikitha Prattipati , Francis M. Sakita , Godfrey L. Kweka , Tumsifu G. Tarimo , Timothy Peterson , Zak Loring , Alexander T. Limkakeng , Gerald S. Bloomfield , Julian T. Hertz
Source
https://doi.org/10.1016/j.afjem.2021.07.002
Date
27 July 2021
Contributor
peri irawan
Format
pdf
Language
english
Type
text
Files
Citation
Isaac O. Oyediran , Sainikitha Prattipati , Francis M. Sakita , Godfrey L. Kweka , Tumsifu G. Tarimo , Timothy Peterson , Zak Loring , Alexander T. Limkakeng , Gerald S. Bloomfield , Julian T. Hertz , “Jurnal internasional Afrika vol.11 issue 4 2021
African Journal of Emergency Medicine
The prevalence, management, and thirty-day outcomes of symptomatic atrial fibrillation in a Tanzanian emergency department,” Repository Horizon University Indonesia, accessed February 6, 2025, https://repository.horizon.ac.id/items/show/1856.
African Journal of Emergency Medicine
The prevalence, management, and thirty-day outcomes of symptomatic atrial fibrillation in a Tanzanian emergency department,” Repository Horizon University Indonesia, accessed February 6, 2025, https://repository.horizon.ac.id/items/show/1856.