Evidence map›Paper›PMID 34627574›Full record

ArticleIndian heart journal

Characteristics of patients presenting to emergency department for primary atrial fibrillation or flutter at an academic medical center.

Murrium I Sadaf, James O'Bryan, Kevin Biese, Sarah Chen, Zachariah Deyo, Phil Mendys, Samuel F Sears, Heather Tuttle, T Jennifer Walker, Anil K Gehi

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Indian heart journal. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 39% 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

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

Murrium I SadafDepartment of Internal Medicine, Yale-New Haven Medical Center, New Haven, CT, USA.
James O'BryanDepartment of Medicine, Virginia Commonwealth University, Richmond, VA, USA.
Kevin BieseDepartment of Emergency Medicine, University of North Carolina, Chapel Hill, NC, USA.
Sarah ChenDivision of Cardiology, Department of Internal Medicine, Chapel Hill, NC, USA.
Zachariah DeyoDepartment of Pharmacy, UNC Medical Center, Chapel Hill, NC, USA.
Phil MendysDepartment of Pharmacy, UNC Medical Center, Chapel Hill, NC, USA; North American Medical Affairs, Pfizer, NY UNC, USA.
Samuel F SearsDepartments of Psychology, Cardiovascular Sciences, and Public Health, East Carolina University, Greenville, NC, USA.
Heather TuttleDepartment of Emergency Medicine, University of North Carolina, Chapel Hill, NC, USA.
T Jennifer WalkerDivision of Cardiology, Department of Internal Medicine, Chapel Hill, NC, USA.
Anil K GehiDivision of Cardiology, Department of Internal Medicine, Chapel Hill, NC, USA. Electronic address: anilgehi@med.unc.edu.
University of North Carolina at Chapel Hill · USUniversity of North Carolina Health Care · USEast Carolina University · USVirginia Commonwealth University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveIn the United States, atrial fibrillation (AF) accounts for over 400,000 hospitalizations annually. Emergency Department (ED) physicians have few resources available to guide AF/AFL (atrial flutter) patient triage, and the majority of these patients are subsequently admitted. Our aim is to describe the characteristics and disposition of AF/AFL patients presenting to the University of North Carolina (UNC) ED with the goal of developing a protocol to prevent unnecessary hospitalizations.

methodsWe performed a retrospective electronic medical chart review of AF/AFL patients presenting to the UNC ED over a 15-month period from January 2015 to March 2016. Demographic and ED visit variables were collected. Additionally, patients were designated as either having primary or secondary AF/AFL where primary AF/AFL patients were those in whom AF/AFL was the primary reason for ED presentation. These primary AF/AFL patients were categorized by AF symptom severity score according to the Canadian Cardiovascular Society Severity of Atrial Fibrillation (CCS-SAF) Scale.

resultsA total of 935 patients presented to the ED during the study period with 202 (21.5%) having primary AF/AFL. Of the primary AF/AFL patients, 189 (93.6%) had mild-moderate symptom severity (CCS-SAF ≤ 3). The majority of primary AF/AFL patients were hemodynamically stable, with a mean (SD) SBP of 123.8 (21.3), DBP of 76.6 (14.1), and ventricular rate of 93 (21.9). Patients with secondary AF/AFL were older 76 (13.1), p < 0.001 with a longer mean length of stay 6.1 (7.7), p = 0.31. Despite their mild-moderate symptom severity and hemodynamic stability, nearly 2/3 of primary AF/AFL patients were admitted.

conclusionDeveloping a protocol to triage and discharge hemodynamically stable AF/AFL patients without severe AF/AFL symptoms to a dedicated AF/AFL clinic may help to conserve healthcare resources and potentially deliver more effective care.

Indexed as

Atrial FibrillationAtrial FlutterCatheter AblationAcademic Medical CentersCanadaEmergency Service, HospitalHumansRetrospective StudiesRisk FactorsEmergency departmentOutpatient follow upPrimary atrial fibrillationPrimary atrial flutterSecondary atrial fibrillationTriage protocol

Identifiers

PMID34627574
PMCPMC8514404
OpenAlexW3193713659

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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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.