title: Care Indicators in Patients With Atrial Fibrillation: Assessment of Sex Differences and Management of Clinical Problems.
abstract: OBJECTIVE
  To assess sex differences and the management of clinical problems in patients with atrial fibrillation through the use of care indicators.
  
  
  METHODS
  Over a 5-month period, the study included all consecutive patients attended in the cardiology outpatient clinics of 2 tertiary hospitals with an atrial fibrillation episode or a clinical process due to atrial fibrillation.
  
  
  RESULTS
  A total of 533 patients were included (56.5% women; mean age, 70.5 ± 12.2 years), of whom 24.3% were younger than 65 years. Women had significantly more clinical problems and a higher stroke risk: CHADS2 (congestive heart failure, hypertension, age, diabetes, stroke [doubled]) (1.8 ± 1.2 vs 1.5 ± 1.1; P = .001) and CHA2DS2-VASc (congestive heart failure, hypertension, age ≥ 75 [doubled], diabetes, stroke [doubled]-vascular disease and sex category [female]) (3.7 ± 1.4 vs 2.2 ± 1.4; P = .0001). Referrals to the cardiology department were appropriate in 94% of the patients, the referral source was primary care or other hospital services in 53.8%, and echocardiography was performed or recommended in 93.4%. Treatment (antiarrhythmics and anticoagulants) was administered according to guideline recommendations. In the previous 3 months, the Rosendaal index was 48.4 ± 37.4.
  
  
  CONCLUSIONS
  One in every 4 patients seeking care for problems associated with atrial fibrillation are young; women have more clinical problems and seek care more frequently than men. Patients are correctly referred to the cardiology department and most are not referred from the emergency department. Echocardiography and antiarrhythmic and anticoagulant therapy were provided according to the recommendations of clinical practice guidelines. Vitamin K antagonists for anticoagulation therapy are underused.
authors.affiliation: Servicio de Cardiología, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain. Electronic address: gbaron@jet.es.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Barón-Esquivias
authors.affiliation: Servicio de Cardiología, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: Gómez
authors.affiliation: Servicio de Cardiología, Hospital Universitario Virgen Macarena, Universidad de Sevilla, Sevilla, Spain.
authors.forename: Helena
authors.initials: H
authors.lastname: Brufau
authors.affiliation: Servicio de Cardiología, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain.
authors.forename: Lorena
authors.initials: L
authors.lastname: García
authors.affiliation: Servicio de Cardiología, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain.
authors.forename: Concepción
authors.initials: C
authors.lastname: Amo
authors.affiliation: Servicio de Cardiología, Hospital Universitario Virgen Macarena, Universidad de Sevilla, Sevilla, Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: Gutiérrez
authors.affiliation: Servicio de Cardiología, Hospital Universitario Virgen Macarena, Universidad de Sevilla, Sevilla, Spain.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Wu
authors.affiliation: Servicio de Cardiología, Hospital Universitario Virgen Macarena, Universidad de Sevilla, Sevilla, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Salmerón
authors.affiliation: Servicio de Cardiología, Hospital Universitario Virgen Macarena, Universidad de Sevilla, Sevilla, Spain.
authors.forename: Santiago
authors.initials: S
authors.lastname: Pinilla
authors.affiliation: Servicio de Cardiología, Hospital Universitario Virgen Macarena, Universidad de Sevilla, Sevilla, Spain.
authors.forename: Víctor
authors.initials: V
authors.lastname: López
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D000925:Anticoagulants / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
chemical_list: D000889:Anti-Arrhythmia Agents; D000925:Anticoagulants
keywords: Atrial fibrillation; Care indicators; Fibrilación auricular; Indicadores asistenciales; Tratamiento; Treatment