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The prevalence, management, and thirty-day outcomes of symptomatic atrial fibrillation in a Tanzanian emergency department.

Publication ,  Journal Article
Oyediran, IO; Prattipati, S; Sakita, FM; Kweka, GL; Tarimo, TG; Peterson, T; Loring, Z; Limkakeng, AT; Bloomfield, GS; Hertz, JT
Published in: Afr J Emerg Med
December 2021

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 participants 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 participants 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.

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Published In

Afr J Emerg Med

DOI

EISSN

2211-4203

Publication Date

December 2021

Volume

11

Issue

4

Start / End Page

404 / 409

Location

Netherlands

Related Subject Headings

  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Oyediran, I. O., Prattipati, S., Sakita, F. M., Kweka, G. L., Tarimo, T. G., Peterson, T., … Hertz, J. T. (2021). The prevalence, management, and thirty-day outcomes of symptomatic atrial fibrillation in a Tanzanian emergency department. Afr J Emerg Med, 11(4), 404–409. https://doi.org/10.1016/j.afjem.2021.07.002
Oyediran, Isaac O., Sainikitha Prattipati, Francis M. Sakita, Godfrey L. Kweka, Tumsifu G. Tarimo, Timothy Peterson, Zak Loring, Alexander T. Limkakeng, Gerald S. Bloomfield, and Julian T. Hertz. “The prevalence, management, and thirty-day outcomes of symptomatic atrial fibrillation in a Tanzanian emergency department.Afr J Emerg Med 11, no. 4 (December 2021): 404–9. https://doi.org/10.1016/j.afjem.2021.07.002.
Oyediran IO, Prattipati S, Sakita FM, Kweka GL, Tarimo TG, Peterson T, et al. The prevalence, management, and thirty-day outcomes of symptomatic atrial fibrillation in a Tanzanian emergency department. Afr J Emerg Med. 2021 Dec;11(4):404–9.
Oyediran, Isaac O., et al. “The prevalence, management, and thirty-day outcomes of symptomatic atrial fibrillation in a Tanzanian emergency department.Afr J Emerg Med, vol. 11, no. 4, Dec. 2021, pp. 404–09. Pubmed, doi:10.1016/j.afjem.2021.07.002.
Oyediran IO, Prattipati S, Sakita FM, Kweka GL, Tarimo TG, Peterson T, Loring Z, Limkakeng AT, Bloomfield GS, Hertz JT. The prevalence, management, and thirty-day outcomes of symptomatic atrial fibrillation in a Tanzanian emergency department. Afr J Emerg Med. 2021 Dec;11(4):404–409.

Published In

Afr J Emerg Med

DOI

EISSN

2211-4203

Publication Date

December 2021

Volume

11

Issue

4

Start / End Page

404 / 409

Location

Netherlands

Related Subject Headings

  • 3202 Clinical sciences