Lower educational attainment is an independent risk factor for unplanned hospitalizations among patients with atrial fibrillation

Abstract Background Studies showed an association between low socioeconomic status and negative outcomes in AF, including worse prognosis, elevated cardiovascular events, and mortality rates. Aim Can a personalized educational intervention effectively reduce unplanned hospitalizations across all educational levels in patients with AF? Method Patients presenting to the emergency department due to AF were randomized to the usual care or receive two in-home educational visits. The outcome of unplanned hospitalizations was analysed according to initial randomization and by education status. Results Participants with lower education were more likely to be female (P .001) and living alone (P =0.03) and have higher rates of hypertension (P .001), and dyslipidemia (P .001), and stroke/TIA (P .0001) compared with those with higher education levels. Participants with lower education status were more likely to be hospitalized for AF-related causes (25% vs 17%, P = .014). We conducted a Poisson regression analysis to examine the factors associated with unplanned hospitalizations. The final model showed that higher education level (IRR = 0.68, 95% CI 0.51, 0.90) and intervention group (IRR = 0.73, 95% CI 0.55, 0.94) were associated with a reduced incidence of unplanned hospitalizations. The presence of sleep apnea (IRR = 1.79, 95% CI 1.42, 2.27) and age65 (IRR = 1.75, 95% CI 1.38, 2.20) were associated with an increased incidence of hospitalizations. Living with a partner was associated with fewer hospitalizations (IRR = 0.63, 95% CI 0.51, 0.78). Conclusion/ clinical implication These findings suggest that targeted interventions, along with addressing socioeconomic disparities, could help mitigate hospitalizations in AF patients.