Trends of Hospitalization for Atrial Fibrillation in the United States, 2000 Through 2010: Implications for Healthcare Planning
Background—Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. The associated morbidity and mortality makes AF a major public health burden. Hospitalizations account for the majority of the economic cost burden associated with AF. The main objective of this study is to examine trends of AF related hospitalizations in the US and to compare patient characteristics, outcomes, and comorbid diagnoses.
Methods and Results—With the use of Nationwide Inpatient Sample (NIS) from 2000 through 2010, AF related hospitalizations were identified using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), code 427.31 as the principal discharge diagnosis. Overall AF hospitalizations increased by 23% from 2000-2010, particularly in patients 65 years or older. The most frequent coexisting conditions were hypertension (60.0%), diabetes (21.5%) and chronic pulmonary disease (20.0%). Overall in-hospital mortality was 1%. The mortality rate was highest in ≥ 80 years age group (1.9%) and patients with concomitant heart failure (8.2%). In-hospital mortality rate decreased significantly from 1.2% in 2000 to 0.9 in 2010 (29.2% decrease, p <0.001). Although there was no significant change in mean LOS; mean cost of AF hospitalization increased significantly from $6,410 in 2001 to $8,439 in 2010 (24.0% increase, p <0.001).
Conclusions—Hospitalization rates for AF have increased exponentially among US adults from 2000 to 2010. Proportion of comorbid chronic diseases has also increased significantly. The last decade has witnessed an overall decline in hospital mortality however the hospitalization cost has significantly increased.
- Received January 2, 2014.
- Revision received February 17, 2014.
- Accepted March 14, 2014.