Abstract 15749: Burden of Atrial Fibrillation on the Hospitals in USA: Analysis of Nationwide Emergency Department Sample Data
Introduction: Atrial Fibrillation (AF) is a major health problem with high burden on healthcare in USA. This study was done to analyze the trend of burden imposed by AF on hospitals in USA and identify factors associated with high rate of hospitalizations.
Methods: We used Nationwide Emergency Department (ED) Sample data to extract data for patients who visited ED with first listed diagnosis of AF using International Classification Disease 9 code of 427.31. Data was extracted for the years 2006 to 2011. Admission rate to hospitals from ED visits and in-hospital mortality for admitted patients was calculated. Sub-analysis was done to determine demographic parameters, hospital status and geographical regions associated with high admission rate.
Results: We identified a total of 2,712, 029 ED visits with first listed diagnosis of AF for the years 2006-2011 with average admission rate of 65.35%. The rate of ED visits steadily increased by approximately 24% from 133 visits per 100,000 persons in 2006 to 164.9 visits per 100,000 persons in 2011 (p<0.01). The admission rate of patients visiting ED with first listed diagnosis of AF stayed fairly constant varying from 62.5% to 67% for the time period 2006-11. The in-hospital mortality for admitted patients decreased from 1.18% in 2006 to 0.97% in 2011 (p<0.01).
Sub-analysis revealed that patients with older age, female gender, Medicare or Medicaid insurance and living in areas with low median income for zip code were associated with higher admission rates from ED visits (p<0.01). Also, hospitals in North-east region of USA, metropolitan areas and teaching hospitals were associated with high admission rates for patients with AF (p<0.01).
Conclusions: This study reveals increasing burden of atrial fibrillation on US hospitals with 24% increase in ED visits from 2006-2011. The decreasing in-hospital mortality rate points to improving care of hospitalized patients. Though the admission rates from ED visits has stayed fairly constant, the absolute numbers have increased. Also, there are huge demographic and geographic variations in admission rates indicating the unmet need for potential interventions to decrease hospitalization rates.
Author Disclosures: S. Aggarwal: None. V. Gupta: None.
- © 2014 by American Heart Association, Inc.