Characteristics of adults with atrial fibrillation aged ≥65 years on care home entry (2003–2018) within the SAIL Databank, by prescription of oral anticoagulation
| Characteristics | All participants with AF (N = 14 493) | Participants with AF not prescribed OACs (n = 7436) | Participants with AF prescribed OACsa (n = 7057) | P-value |
|---|---|---|---|---|
| Demographics | ||||
| Age, years, median (IQR) | 87.0 (82.6–91.2) | 87.9 (83.4–92.0) | 86.2 (81.9–90.2) | <0.001 |
| Age category, years, n (%) | <0.001 | |||
| 65–74 | 770 (5.3) | 341 (4.6) | 429 (6.1) | |
| 75–84 | 4682 (32.3) | 2117 (28.5) | 2565 (36.3) | |
| 85–94 | 7859 (54.2) | 4157 (55.9) | 3702 (52.5) | |
| ≥95 | 1182 (8.2) | 821 (11.0) | 361 (5.1) | |
| Sex, male, n (%) | 5103 (35.2) | 2427 (32.6) | 2676 (37.9) | <0.001 |
| WIMD quintile, n (%) | 1.000 | |||
| 1 (most deprived) | 2459 (17.0) | 1270 (17.2) | 1189 (17.1) | |
| 2 | 3053 (21.3) | 1567 (21.2) | 1486 (21.4) | |
| 3 | 3435 (23.9) | 1774 (24.0) | 1661 (23.9) | |
| 4 | 2842 (19.8) | 1468 (19.9) | 1374 (19.8) | |
| 5 (least deprived) | 2554 (17.8) | 1316 (17.8) | 1238 (17.8) | |
| Missing | 150 (1.0) | 41 (0.3) | 109 (0.8) | |
| Frailty, n (%) | <0.001 | |||
| No frailty | 1864 (12.9) | 1600 (21.5) | 264 (3.7) | |
| Mild | 3714 (25.6) | 2142 (28.8) | 1572 (22.3) | |
| Moderate | 5145 (35.5) | 2329 (31.3) | 2816 (39.9) | |
| Severe | 3770 (26.0) | 1365 (18.4) | 2405 (34.1) | |
| Stroke risk, CHA2DS2-VASc score,b median (IQR) | 4 (3–5) | 4 (3–5) | 4 (3–5) | <0.001 |
| Bleeding risk, HAS-BLED score,b median (IQR) | 3 (2–3) | 2 (2–3) | 3 (2–3) | <0.001 |
| Social history, n (%) | ||||
| Smoking history | 3996 (27.6) | 1620 (21.8) | 2376 (33.7) | <0.001 |
| Alcoholism | 1223 (8.4) | 513 (6.9) | 710 (10.1) | <0.001 |
| Heavy drinker | 224 (1.5) | 118 (1.6) | 106 (1.5) | 0.680 |
| Comorbiditiesc | ||||
| Any stroke | 2929 (20.2) | 1248 (16.8) | 1681 (23.8) | <0.001 |
| Stroke (unknown origin) | 618 (4.3) | 266 (3.6) | 352 (5.0) | <0.001 |
| Ischaemic stroke | 2232 (15.4) | 932 (12.5) | 1300 (18.4) | <0.001 |
| Haemorrhagic stroke | 336 (2.3) | 144 (1.9) | 192 (2.7) | 0.002 |
| Transient ischaemic attack | 796 (5.5) | 361 (4.9) | 435 (6.2) | <0.001 |
| Myocardial infarction | 1131 (7.8) | 560 (7.5) | 571 (8.1) | 0.210 |
| Heart failure | 4204 (29.0) | 1796 (24.2) | 2408 (34.1) | <0.001 |
| Alzheimer’s disease | 162 (1.1) | 93 (1.3) | 69 (1.0) | 0.120 |
| Vascular dementia | 552 (3.8) | 275 (3.7) | 277 (3.9) | 0.480 |
| Other dementia or unspecified | 542 (3.7) | 306 (4.1) | 236 (3.3) | 0.014 |
| Asthma | 1214 (8.4) | 512 (6.9) | 702 (9.9) | <0.001 |
| Chronic obstructive pulmonary disease | 1794 (12.4) | 811 (10.9) | 983 (13.9) | <0.001 |
| Other pulmonary disease | 9 (0.1) | <5 (<1) | 7 (0.1) | 0.081 |
| Peptic ulcer | 422 (2.9) | 215 (2.9) | 207 (2.9) | 0.880 |
| Diabetes | 728 (5.0) | 299 (4.0) | 429 (6.1) | <0.001 |
| Renal disease | 1052 (7.3) | 457 (6.1) | 595 (8.4) | <0.001 |
| Liver disease | 45 (0.3) | 25 (0.3) | 20 (0.3) | 0.570 |
| Cancer | 2236 (15.4) | 1055 (14.2) | 1181 (16.7) | <0.001 |
| Hypertension | 6967 (48.1) | 3125 (42.0) | 3842 (54.4) | <0.001 |
| Dyslipidaemia | 1765 (12.2) | 679 (9.1) | 1086 (15.4) | <0.001 |
| Peripheral vascular disease | 855 (5.9) | 352 (4.7) | 503 (7.1) | <0.001 |
| Aortic plaque | 8 (0.1) | <5 (<1) | 5 (0.1) | 0.430 |
| Major bleeding | 2635 (18.2) | 1095 (14.7) | 1540 (21.8) | <0.001 |
| Venous thromboembolism | 464 (3.2) | 93 (1.3) | 371 (5.3) | <0.001 |
↵a Prescription within 6 months before care home entry used as a proxy for prescription at the point of care home entry.
↵b CHA2DS2-VASc, stroke risk assessment scoring one point each for female sex, age 65–74 years, history of heart failure, diabetes, hypertension, vascular disease, and two points each for history of stroke/transient ischaemic attack/venous thromboembolism and age ≥75 years. HAS-BLED, bleeding risk assessment scoring one point each for age >65 years, uncontrolled hypertension, liver disease, renal disease, harmful alcohol use, stroke history, prior major bleeding or a predisposition to bleeding, labile international normalised ratio, and medication usage predisposing to bleeding. See Supplementary Tables S4 and S5 for definitions of the HAS-BLED and CHA2DS2-VASc risk assessment scores used in this study.
↵c Younger-onset dementia not reported on because of small numbers and risk of resident identification.
AF = atrial fibrillation. IQR = interquartile range. OAC = oral anticoagulation. SAIL = Secure Anonymised Information Linkage. WIMD = Welsh Index of Multiple Deprivation.