Volume 19 Issue 11
Nov.  2021
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LIN Chun-zhong, ZHAO Liang, WANG Zhao-xin, BIE Zi-dong. Current situation and influencing factors of anticoagulant therapy for patients with atrial fibrillation in county hospitals based on data mining[J]. Chinese Journal of General Practice, 2021, 19(11): 1951-1955. doi: 10.16766/j.cnki.issn.1674-4152.002209
Citation: LIN Chun-zhong, ZHAO Liang, WANG Zhao-xin, BIE Zi-dong. Current situation and influencing factors of anticoagulant therapy for patients with atrial fibrillation in county hospitals based on data mining[J]. Chinese Journal of General Practice, 2021, 19(11): 1951-1955. doi: 10.16766/j.cnki.issn.1674-4152.002209

Current situation and influencing factors of anticoagulant therapy for patients with atrial fibrillation in county hospitals based on data mining

doi: 10.16766/j.cnki.issn.1674-4152.002209
Funds:

 71774116

 17692105200

  • Received Date: 2021-01-27
    Available Online: 2022-02-15
  •   Objective  To understand the current situation and influencing factors of anticoagulant therapy for patients with atrial fibrillation in county-level hospitals in eastern China, and to optimise anticoagulant treatment, prevent stroke and reduce disease burden of these patients in the future.  Methods  Through retrospective analysis of the diagnosis, treatment and prescription data of 2 452 patients with atrial fibrillation in three county-level hospitals in eastern China from 2018 to 2019, the basic situation of these patients was described and analysed, and the differences of anticoagulation in different dimensions and the influencing factors of anticoagulation treatment were compared.  Results  The overall anticoagulation rate of three county-level hospitals was 49.96%, and the anticoagulation rate of patients whose CHA2DS2-VASc score ≥ 2 was 50.4%. Significant differences were observed in the anticoagulation rate amongst different admission years, admission departments, age groups, combined diseases and bleeding risk groups (all P < 0.05). A CRT decision tree model was constructed to analyse the influencing factors of anticoagulation in county-level hospitals. Finally, 15 variables including main diagnosis of atrial fibrillation, coronary heart disease, heart failure, number of comorbid diseases, department of admission, risk of stroke and bleeding, CHA2DS2-VASc score were included. The accuracy of the model was 65.0%, and the area under the ROC curve was 0.70.  Conclusion  The anticoagulation rate of patients with atrial fibrillation in county hospitals in eastern China has improved to a certain extent, but there is still room for improvement compared with tertiary hospitals. In addition, the anticoagulation standardization of doctors in county-level hospitals needs to be improved, and the training of doctors in county-level hospitals in anticoagulation treatment of atrial fibrillation still needs to be strengthened in the future.

     

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