3 years ago

Emergency Department, Hospital Inpatient, and Mortality Burden of Atrial Fibrillation in the United States, 2006-2014

The prevalence of atrial fibrillation (AF) is increasing in the United States as the population ages, but national surveillance is lacking. This cross-sectional study (2006-2014) analyzed data from the Healthcare Cost and Utilization Project's Nationwide ED Sample, the Nationwide/National Inpatient Sample, and the National Vital Statistics System. Event totals were estimated independently for ED visits, hospitalizations, and mortality, and then collectively after applying criteria to identify mutually exclusive events. Rates were calculated for AF as primary diagnosis/underlying cause of death (primary AF) as well as secondary diagnosis/contributing cause of death (comorbid AF), and standardized by age to the 2010 US population. From 2006-2014, event rates increased for primary AF (249 to 268 per 100,000) and comorbid AF (1,473 to 1,835 per 100,000). In 2014, an estimated 599,790 ED visits, 453,060 hospitalizations, and 21,712 deaths listed AF as primary. A total of 684,470 mutually exclusive primary AF and 4,695,997 mutually exclusive comorbid AF events occurred. Among ED visits and hospitalizations with primary AF, the most common secondary diagnoses were hypertension, heart failure, ischemic heart disease, and diabetes. The mean cost per hospitalization with primary AF was $8,819. Mean costs were higher for those with comorbid AF vs. those without among hospitalizations with a primary diagnosis of ischemic heart disease, heart failure, stroke, hypertension, or diabetes (all p≤0.01). In conclusion, with substantial health and economic impact of AF and an aging US population, improved diagnosis, prevention, management, and surveillance of AF is increasingly important.

Publisher URL: www.sciencedirect.com/science

DOI: S0002914917313875

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