title: Educational inequalities in mortality of patients with atrial fibrillation in Norway.
abstract: OBJECTIVE
  We explored the educational gradient in mortality in atrial fibrillation (AF) patients.
  
  
  METHODS
  We prospectively followed patients hospitalized with AF as primary discharge diagnosis in the Cardiovascular Disease in Norway 2008-2012 project. The average length of follow-up was 2.4 years. Mortality by educational level was assessed by Cox proportional hazard models. Population attributable fractions (PAF) were calculated. Analyses stratified by age (≤75 and >75 years of age), and adjusted for age, gender, medical intervention, and Charlson Comorbidity Index.
  
  
  RESULTS
  Of 42,138 AF patients, 16% died by end of 2012. Among younger patients, those with low education (≤10 years) had a HR of 2.3 (95% confidence interval 2.0, 2.6) for all-cause mortality relative to those with any college or university education. Similar results were observed for cardiovascular mortality. Disparities in mortality were greater among younger than older patients. A PAF of 35.9% (95% confidence interval 27.9, 43.1) was observed for an educational level of high school/vocational school or less versus higher education in younger patients.
  
  
  CONCLUSIONS
  Increasing educational level associated with better prognosis suggesting underlying education-related behavioral and medical determinants of mortality. A considerable proportion of mortality within 5 years following hospital discharge could be prevented.
authors.affiliation: a Domain for Health Data and Digitalization , Norwegian Institute of Public Health , Bergen , Norway.
authors.forename: Rupali
authors.initials: R
authors.lastname: Akerkar
authors.affiliation: a Domain for Health Data and Digitalization , Norwegian Institute of Public Health , Bergen , Norway.
authors.forename: Marta
authors.initials: M
authors.lastname: Ebbing
authors.affiliation: b Department of Global Public Health and Primary Care , University of Bergen , Bergen , Norway.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Sulo
authors.affiliation: c Domain for Mental and Physical Health , Norwegian Institute of Public Health , Oslo , Norway.
authors.forename: Inger
authors.initials: I
authors.lastname: Ariansen
authors.affiliation: b Department of Global Public Health and Primary Care , University of Bergen , Bergen , Norway.
authors.forename: Jannicke
authors.initials: J
authors.lastname: Igland
authors.affiliation: a Domain for Health Data and Digitalization , Norwegian Institute of Public Health , Bergen , Norway.|b Department of Global Public Health and Primary Care , University of Bergen , Bergen , Norway.
authors.forename: Grethe S
authors.initials: GS
authors.lastname: Tell
authors.affiliation: a Domain for Health Data and Digitalization , Norwegian Institute of Public Health , Bergen , Norway.|b Department of Global Public Health and Primary Care , University of Bergen , Bergen , Norway.
authors.forename: Grace M
authors.initials: GM
authors.lastname: Egeland
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000401:mortality* / Q000523:psychology; D002423:Cause of Death; D016009:Chi-Square Distribution; D015897:Comorbidity; D004522:Educational Status; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors
keywords: Atrial fibrillation; cardiovascular disease; education; epidemiology; mortality