The Effect of Age on 1-Year Readmissions in Atrial Fibrillation Patients: Trends and Insights From a Conflict-Stricken Country

Background

Atrial fibrillation (AF) is a leading cause of cardiovascular morbidity and hospitalization worldwide. However, limited data exist on AF readmissions in low-resource and conflict-affected settings. This study investigates the impact of age on 1-year readmission rates among AF patients in a Syrian tertiary hospital.

Methods

This retrospective observational cohort study was conducted at a tertiary Syrian center between June/2021–November/2023. Patients admitted with primary AF were included, while those with secondary AF or missing demographic data were excluded. Patients were stratified into three age groups: 18–50 years (Group 1), 51–70 years (Group 2), and > 70 years (Group 3). The primary outcome was all-cause and cardiovascular-related 1-year readmissions, with secondary outcomes including readmission frequencies.

Results

A total of 657 AF patients were included, with a median age of 60 320 (52%) were males. One-year readmission occurred in 64% of patients, with AF being the most common cause (75%). Group 1 had the highest smoking rates (70%). Group 3 had the highest rates of ischemic heart disease (47%), congestive cardiac failure (CCF) (35%), chronic kidney disease (15%, p < 0.001) and chronic liver disease (20). Older age was significantly associated with increased readmissions (87% in Group 3 vs. 62% in Group 2 and 49% in Group 1, p < 0.001). Frequent readmissions were more prevalent in Group 3 (≥ 3 admissions: 46%).

Conclusion

Older AF patients in a conflict-affected setting experience significantly higher readmission rates. Addressing healthcare resource limitations and optimizing AF management strategies are crucial to improving outcomes in resource-limited settings.