Atrial-Fibrillation Hospitalizations, Costs, Soar as Mortality Dips

Shelley Wood

May 20, 2014

NEW YORK, NY — Hospitalizations for atrial fibrillation (AF) rose 23% in the US over an 11-year period, with the largest increases seen in people 65 and older, a new study has found[1]. Encouragingly, mortality for an AF admission declined between 2000 and 2010, while costs were up by almost 25%.

"The rise in AF admission is likely due to aging of the general population and increasing prevalence of risk factors like hypertension, obesity, sleep apnea, and diabetes," Dr Nileshkumar J Patel (Staten Island University Hospital, NY) and colleagues write.

They looked at AF-related hospitalizations in the Nationwide Inpatient Sample identifying patients with AF as their principal discharge diagnosis based on ICD-9 code. Overall, there were just under four million hospitalizations with AF as the primary discharge diagnosis, a number that rose from 312 926 in 2000 to 409 854 in 2010. More women were diagnosed with AF over the study period, although the gap between men and women closed over the decade of study.

Among the other key findings:

  • Southern hospitals had the highest proportion of AF hospitalizations, at 38.5%, while the West had the lowest (14.4%).

  • Older subjects had the highest rate of AF hospitalization and had the biggest increases over the study period.

  • Deaths due to AF declined from a rate of 1.2% in 2000 to 0.9% in 2010 and were highest among patients with concomitant heart failure or those older than 80.

  • Hypertension was the most common coexisting condition (seen in 60% of hospitalizations), followed by diabetes and pulmonary diseases, in about 20% each.

  • Costs of AF hospitalizations rose from approximately $6400 in 2000 to $8500 in 2010.

The analysis included more than 1200 hospitals in 45 states, the authors note. According to the American Heart Association, at least 2.7 million people are living with AF in the US, and that number is expected to rise with an aging population and growing rates of obesity and other risk factors.

"We must treat atrial fibrillation and its risk factors better in the outpatient setting to prevent hospitalizations and reduce its staggering impact," study coauthor Dr Abhishek Deshmukh (University of Arkansas for Medical Sciences, Little Rock) commented in a press release.

Drs Patel and Deshmukh have no conflicts of interest. Disclosures for the coauthors are listed in the article.

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