title: Real-world management of atrial fibrillation in Internal Medicine units:  the FADOI 'FALP' observational study.
abstract: BACKGROUND
  Atrial fibrillation is the most frequent arrhythmia, but few data are available on patients' characteristics and management in the context of Internal Medicine wards.
  
  
  METHODS
  Data were collected at the beginning of 2010 in 18 Internal Medicine units of the regions Liguria and Piemonte (Italy). Each centre reviewed the hospital charts of the last 50 patients discharged during the year 2009 in whom a diagnosis of atrial fibrillation had been made (patient's history or during the hospitalization).
  
  
  RESULTS
  A total of 903 atrial fibrillation patients were evaluated. Prevalence of atrial fibrillation among patients hospitalized in Internal Medicine units was 18.2%. More than 85% of patients had at least two diseases other than atrial fibrillation, and 'lone' atrial fibrillation was rare (1.3%). During hospital stay, 80.5% of the patients received at least one treatment for atrial fibrillation: 55.5% received an antithrombotic and 61.8% a drug for arrhythmia, mostly aimed at rate control (47.2%). In-hospital all-cause mortality was 13.4%. At discharge, 70.2 and 68.9% of the patients received prescription of a drug for arrhythmia and for antithrombotic treatment, respectively. Prescription of oral anticoagulants was significantly associated with hypertension, while previous bleeding, age above 75 years, paroxysmal atrial fibrillation, male sex and a number of concomitant drugs of more than four were strong negative predictors.
  
  
  CONCLUSIONS
  Data from our study confirm that atrial fibrillation is a common finding in patients hospitalized in Internal Medicine units, and this population is characterized by multiple comorbidities and severe prognosis. Discrepancies exist between recommendations by guidelines and real-world management, owing to the complexity of patients and limits of existing treatment strategies.
authors: Department of Internal Medicine, Hospital Maggiore della Carità, Novara, Italy.
authors: Mauro
authors: M
authors: Campanini
authors: Roberto
authors: R
authors: Frediani
authors: Alberto
authors: A
authors: Artom
authors: Giuliano
authors: G
authors: Pinna
authors: Antonella
authors: A
authors: Valerio
authors: Micaela
authors: M
authors: La Regina
authors: Stefania
authors: S
authors: Marengo
authors: Giuliano
authors: G
authors: Lo Pinto
authors: Erica
authors: E
authors: Del Signore
authors: Erminio
authors: E
authors: Bonizzoni
authors: Giovanni
authors: G
authors: Mathieu
authors: Antonino
authors: A
authors: Mazzone
authors: Giorgio
authors: G
authors: Vescovo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D015897:Comorbidity; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007388:Internal Medicine / Q000592:standards / Q000706:statistics & numerical data; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data; D015995:Prevalence; D012189:Retrospective Studies