Abstract 19718: Incidence of Atrial Fibrillation and Associated Mortality among Medicare Beneficiaries from 1993 to 2007
Background: Atrial fibrillation (AF) is a common and costly problem in the elderly. The frequency of AF increases with age, but representative national data about incidence and associated mortality are limited. Accordingly, we estimated the annual incidence of AF and associated survival in elderly persons from 1993 through 2007.
Methods: Using the Medicare 5% sample research identifiable files, we conducted a retrospective study of fee-for-service Medicare beneficiaries aged 65 years and older. The main measures of interest were the annual incidence of AF and mortality following an incident diagnosis. We defined AF with a single inpatient diagnosis or 2 outpatient diagnoses within 365 days. We also described characteristics of beneficiaries with incident AF across the study period. All analyses were age- and sex-adjusted to the Medicare population aged 65 years and older in 2000.
Results: Over the study period, there were 433,123 patients with incident AF. The mean age was 80, 45% were women, and 92% were white. The incidence of AF per 1000 person-years remained relatively stable across time, from a low of 27.0 in 2007 to a high of 29.3 in 1997. Among beneficiaries with AF in 2007, 36% had heart failure, 84% were hypertensive, 30% had cerebrovascular disease, and 8% had dementia. Mortality following incident AF declined slightly from 1993 to 2007, but mortality rates remained high. In 2007, age- and sex-adjusted mortality was 10% at 30 days and 24% at 1-year (Figure).
Conclusions: Incident AF is common and has remained relatively stable for more than a decade. Incident AF is associated with significant comorbidity and mortality; death occurs in one-quarter of beneficiaries within 1 year.
- © 2010 by American Heart Association, Inc.