Evidence map›Paper›PMID 29241636›Full record

ArticleHeart rhythm2018

Urban-rural differences in mortality for atrial fibrillation hospitalizations in the United States.

Wesley T O'Neal, Pratik B Sandesara, Heval M Kelli, Sanjay Venkatesh, Elsayed Z Soliman

Open access · greenAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Heart rhythm, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 1 pooled it
1.6field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

34 citing papers in PubMed, 1 synthesis or guideline pooled it, 54 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Observational
  4. Article
  5. Regional disparities in the care and outcomes of atrial fibrillation patients in a universal health care system: a population-based cohort study.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025
    Article
  6. Article
  7. Review
  8. Article
  9. Atrial fibrillation in the Americas.Lancet regional health. Americas · 2025
    Review
  10. Article
  11. Article
  12. Review
  13. Article
  14. Article
  15. Article
  16. Article
  17. Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Wesley T O'NealDivision of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia. Electronic address: wesley.oneal@emory.edu.
Pratik B SandesaraDivision of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
Heval M KelliDivision of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
Sanjay VenkateshDepartment of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.
Elsayed Z SolimanSection on Cardiology, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina; Epidemiological Cardiology Research Center, Wake Forest School of Medicine, Winston-Salem, North Carolina.
Emory University · USWake Forest University · US

Funding

The Association between Acute Mental Stress and Electrocardiographic Left Atrial AbnormalitiesF32HL134290 · NHLBI · EMORY UNIVERSITY · PI O'NEAL, WESLEY T · 2016 to 2017
$122k
NHLBI NIH HHS F32 HL134290
6 · The paper itself

Abstract

backgroundCardiovascular outcomes vary between urban and rural hospitals, with worse outcomes in rural settings.

objectiveThe purpose of this study was to examine whether in-hospital mortality for hospitalization for atrial fibrillation (AF) varied between urban and rural hospitals.

methodsA cross-sectional examination of patients who were hospitalized for AF was performed in the National Inpatient Sample between 2012 and 2014 to compare in-hospital mortality in patients admitted to urban vs rural hospitals. Patients with a principal International Classification of Diseases, Ninth Revision discharge diagnosis of AF were included. Hospitals were classified as urban or rural on the basis of core-based statistical areas. In-hospital mortality was defined as death due to any cause during hospitalization.

resultsA total of 248,731 (mean age 69 years; 78% white; 48% women) admissions for AF were identified. Of these, 218,946 (88%) were from urban hospitals and 29,785 (12%) were from rural hospitals. Patients admitted to rural hospitals had a 17% increased risk of death as compared with those admitted to urban hospitals in a multivariable model, which accounted for differences in patient characteristics and potential confounders (odds ratio 1.17; 95% confidence interval 1.04-1.32). Similar results were obtained in a propensity score-matched analysis and in subgroup analyses by sex, race, and region.

conclusionIn-hospital mortality of AF is higher in rural hospitals than in urban hospitals. Further research is needed to understand this finding and to develop targeted strategies to reduce mortality in patients admitted for AF in rural hospitals.

Indexed as

Hospitals, RuralHospitals, UrbanRisk AssessmentAgedAtrial FibrillationCross-Sectional StudiesFemaleHospitalizationHospital MortalityHumansMaleOdds RatioRetrospective StudiesSurvival RateUnited StatesAtrial fibrillationHospitalizationIn-hospital mortalityOutcomesRural

Identifiers

PMID29241636
PMCPMC5801039
OpenAlexW2771858735

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.