The Effect Of Preadmission Warfarin On Ischemic Stroke Severity And Hospitalization Costs In Patients With Atrial Fibrillation

Objective: To provide evidence for reducing disease burden of stroke in patients with atrial fibrillation,we evaluated the association between preadmission antithrombotic treatment and stroke severity,hospitalization costs in patients with ischemic stroke and atrial fibrillation.Methods: In 9 hospitals involved in Chinese Atrial Fibrillation Registry,We identified consecutive atrial fibrillation patients who suffered ischemic stroke or transient ischemic attack from 2012-01-01 to 2014-3-31.Clinical data of the groups was collected and compared,including baseline data,laboratory examination and hospitalization costs.Stroke severity was measured using the NIHSS.Independent risk factors for NIHSS and hospitalization direct costs were also analyzed.Results:Totally 260 patients were enrolled,51(19.6%)were receiving warfarin and 209(80.4%)were without warfarin treatment.NHISS scores of warfarin treatment group were less than the group without warfarin treatment(4.1±4.4 VS 7.9±8.5),and hospitalization costs of the group without warfarin treatment were pretty higher than warfarin treatment group(19597.8 VS16659.7),Difference was statistically significant(P<0.05).Besides,Multivariable analysis showed INR≥2 could reduce the NIHSS score(odds ratio =0.24,95%CI:0.07-0.85,P=0.027),and the direct costs were highly related to preadmission warfarin treatment,(β=-0.10,95% CI:-0.18~-0.02,P=0.018).Conclusion: Warfarin treatment may reduce severity of ischemic stroke and hospitalization costs in patients with atrial fibrillation.