University hospitals, general hospitals, private clinics: Place-based differences in patient characteristics and outcomes of AF—A SAKURA AF Registry Substudy

Abstract Background Relations between characteristics and outcomes of patients in Japan with atrial fibrillation (AF) and the type of medical facility providing their outpatient care are unclear. Methods and results We compared patient characteristics and outcomes between 2 university hospitals ( n  = 1178), 20 general hospitals ( n  = 1308), and 41 private clinics ( n  = 751) (follow-up: 39.3 months) in the prospective SAKURA AF Registry. Private clinic patients were significantly older than university hospital and general hospital patients (73.4 ± 9.2 vs. 70.3 ± 9.8 and 72.6 ± 8.9 years; p 2 scores were significantly lower than general hospital, but higher than university hospital patients (1.8 ± 1.1 vs. 2.0 ± 1.2 and 1.6 ± 1.1; p p  = 0.120), a cardiovascular event (4.09 vs. 2.44 vs. 1.40; p p  = 0.015) for university and general hospital patients than for private clinic patients; the incidences of major bleeding were equivalent (1.78 vs. 1.33 vs. 1.16; p  = 0.273). After multivariate adjustments, this trend persisted. Conclusions Adverse clinical events at small to large hospitals appear to be higher than those at private clinics, suggesting that careful attention for preventing stroke/SE and cardiovascular events should be paid to patients at a university or general hospital.