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Contemporary trends of hospitalization for atrial fibrillation in the United States, 2000 through 2010: implications for healthcare planning.
Circulation. 2014 Jun 10; 129(23):2371-9.Circ

Abstract

BACKGROUND

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. The associated morbidity and mortality make 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 the trends of AF-related hospitalizations in the United States and to compare patient characteristics, outcomes, and comorbid diagnoses.

METHODS AND RESULTS

With the use of the Nationwide Inpatient Sample from 2000 through 2010, we identified AF-related hospitalizations using International Classification of Diseases, 9th Revision, Clinical Modification code 427.31 as the principal discharge diagnosis. Overall AF hospitalizations increased by 23% from 2000 to 2010, particularly in patients ≥65 years of age. The most frequent coexisting conditions were hypertension (60.0%), diabetes mellitus (21.5%), and chronic pulmonary disease (20.0%). Overall in-hospital mortality was 1%. The mortality rate was highest in the group of patients ≥80 years of age (1.9%) and in the group of 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 length of stay, mean cost of AF hospitalization increased significantly from $6410 in 2001 to $8439 in 2010 (24.0% increase; P<0.001).

CONCLUSIONS

Hospitalization rates for AF have increased exponentially among US adults from 2000 to 2010. The 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.

Authors+Show Affiliations

From the Staten Island University Hospital, Staten Island, NY (N.J.P., N.S., V.P., J.L., M.K.); University of Arkansas, Little Rock (A.D., S.P., J.L.M., H.P.); University of Miami Miller School of Medicine, Miami, FL (V.S., G.T.S., R.D.M., J.F.V.-G.); Detroit Medical Centre, Detroit, MI (N.P., S.A., A.O.B.); MedStar Washington Hospital Center, Washington, DC (A.C.); UPMC Shadyside, Pittsburgh, PA (K.M.); and Cedar-Sinai Medical Center, Los Angeles, CA (A.R.). dr.nilesh.j.patel@gmail.com.From the Staten Island University Hospital, Staten Island, NY (N.J.P., N.S., V.P., J.L., M.K.); University of Arkansas, Little Rock (A.D., S.P., J.L.M., H.P.); University of Miami Miller School of Medicine, Miami, FL (V.S., G.T.S., R.D.M., J.F.V.-G.); Detroit Medical Centre, Detroit, MI (N.P., S.A., A.O.B.); MedStar Washington Hospital Center, Washington, DC (A.C.); UPMC Shadyside, Pittsburgh, PA (K.M.); and Cedar-Sinai Medical Center, Los Angeles, CA (A.R.).From the Staten Island University Hospital, Staten Island, NY (N.J.P., N.S., V.P., J.L., M.K.); University of Arkansas, Little Rock (A.D., S.P., J.L.M., H.P.); University of Miami Miller School of Medicine, Miami, FL (V.S., G.T.S., R.D.M., J.F.V.-G.); Detroit Medical Centre, Detroit, MI (N.P., S.A., A.O.B.); MedStar Washington Hospital Center, Washington, DC (A.C.); UPMC Shadyside, Pittsburgh, PA (K.M.); and Cedar-Sinai Medical Center, Los Angeles, CA (A.R.).From the Staten Island University Hospital, Staten Island, NY (N.J.P., N.S., V.P., J.L., M.K.); University of Arkansas, Little Rock (A.D., S.P., J.L.M., H.P.); University of Miami Miller School of Medicine, Miami, FL (V.S., G.T.S., R.D.M., J.F.V.-G.); Detroit Medical Centre, Detroit, MI (N.P., S.A., A.O.B.); MedStar Washington Hospital Center, Washington, DC (A.C.); UPMC Shadyside, Pittsburgh, PA (K.M.); and Cedar-Sinai Medical Center, Los Angeles, CA (A.R.).From the Staten Island University Hospital, Staten Island, NY (N.J.P., N.S., V.P., J.L., M.K.); University of Arkansas, Little Rock (A.D., S.P., J.L.M., H.P.); University of Miami Miller School of Medicine, Miami, FL (V.S., G.T.S., R.D.M., J.F.V.-G.); Detroit Medical Centre, Detroit, MI (N.P., S.A., A.O.B.); MedStar Washington Hospital Center, Washington, DC (A.C.); UPMC Shadyside, Pittsburgh, PA (K.M.); and Cedar-Sinai Medical Center, Los Angeles, CA (A.R.).From the Staten Island University Hospital, Staten Island, NY (N.J.P., N.S., V.P., J.L., M.K.); University of Arkansas, Little Rock (A.D., S.P., J.L.M., H.P.); University of Miami Miller School of Medicine, Miami, FL (V.S., G.T.S., R.D.M., J.F.V.-G.); Detroit Medical Centre, Detroit, MI (N.P., S.A., A.O.B.); MedStar Washington Hospital Center, Washington, DC (A.C.); UPMC Shadyside, Pittsburgh, PA (K.M.); and Cedar-Sinai Medical Center, Los Angeles, CA (A.R.).From the Staten Island University Hospital, Staten Island, NY (N.J.P., N.S., V.P., J.L., M.K.); University of Arkansas, Little Rock (A.D., S.P., J.L.M., H.P.); University of Miami Miller School of Medicine, Miami, FL (V.S., G.T.S., R.D.M., J.F.V.-G.); Detroit Medical Centre, Detroit, MI (N.P., S.A., A.O.B.); MedStar Washington Hospital Center, Washington, DC (A.C.); UPMC Shadyside, Pittsburgh, PA (K.M.); and Cedar-Sinai Medical Center, Los Angeles, CA (A.R.).From the Staten Island University Hospital, Staten Island, NY (N.J.P., N.S., V.P., J.L., M.K.); University of Arkansas, Little Rock (A.D., S.P., J.L.M., H.P.); University of Miami Miller School of Medicine, Miami, FL (V.S., G.T.S., R.D.M., J.F.V.-G.); Detroit Medical Centre, Detroit, MI (N.P., S.A., A.O.B.); MedStar Washington Hospital Center, Washington, DC (A.C.); UPMC Shadyside, Pittsburgh, PA (K.M.); and Cedar-Sinai Medical Center, Los Angeles, CA (A.R.).From the Staten Island University Hospital, Staten Island, NY (N.J.P., N.S., V.P., J.L., M.K.); University of Arkansas, Little Rock (A.D., S.P., J.L.M., H.P.); University of Miami Miller School of Medicine, Miami, FL (V.S., G.T.S., R.D.M., J.F.V.-G.); Detroit Medical Centre, Detroit, MI (N.P., S.A., A.O.B.); MedStar Washington Hospital Center, Washington, DC (A.C.); UPMC Shadyside, Pittsburgh, PA (K.M.); and Cedar-Sinai Medical Center, Los Angeles, CA (A.R.).From the Staten Island University Hospital, Staten Island, NY (N.J.P., N.S., V.P., J.L., M.K.); University of Arkansas, Little Rock (A.D., S.P., J.L.M., H.P.); University of Miami Miller School of Medicine, Miami, FL (V.S., G.T.S., R.D.M., J.F.V.-G.); Detroit Medical Centre, Detroit, MI (N.P., S.A., A.O.B.); MedStar Washington Hospital Center, Washington, DC (A.C.); UPMC Shadyside, Pittsburgh, PA (K.M.); and Cedar-Sinai Medical Center, Los Angeles, CA (A.R.).From the Staten Island University Hospital, Staten Island, NY (N.J.P., N.S., V.P., J.L., M.K.); University of Arkansas, Little Rock (A.D., S.P., J.L.M., H.P.); University of Miami Miller School of Medicine, Miami, FL (V.S., G.T.S., R.D.M., J.F.V.-G.); Detroit Medical Centre, Detroit, MI (N.P., S.A., A.O.B.); MedStar Washington Hospital Center, Washington, DC (A.C.); UPMC Shadyside, Pittsburgh, PA (K.M.); and Cedar-Sinai Medical Center, Los Angeles, CA (A.R.).From the Staten Island University Hospital, Staten Island, NY (N.J.P., N.S., V.P., J.L., M.K.); University of Arkansas, Little Rock (A.D., S.P., J.L.M., H.P.); University of Miami Miller School of Medicine, Miami, FL (V.S., G.T.S., R.D.M., J.F.V.-G.); Detroit Medical Centre, Detroit, MI (N.P., S.A., A.O.B.); MedStar Washington Hospital Center, Washington, DC (A.C.); UPMC Shadyside, Pittsburgh, PA (K.M.); and Cedar-Sinai Medical Center, Los Angeles, CA (A.R.).From the Staten Island University Hospital, Staten Island, NY (N.J.P., N.S., V.P., J.L., M.K.); University of Arkansas, Little Rock (A.D., S.P., J.L.M., H.P.); University of Miami Miller School of Medicine, Miami, FL (V.S., G.T.S., R.D.M., J.F.V.-G.); Detroit Medical Centre, Detroit, MI (N.P., S.A., A.O.B.); MedStar Washington Hospital Center, Washington, DC (A.C.); UPMC Shadyside, Pittsburgh, PA (K.M.); and Cedar-Sinai Medical Center, Los Angeles, CA (A.R.).From the Staten Island University Hospital, Staten Island, NY (N.J.P., N.S., V.P., J.L., M.K.); University of Arkansas, Little Rock (A.D., S.P., J.L.M., H.P.); University of Miami Miller School of Medicine, Miami, FL (V.S., G.T.S., R.D.M., J.F.V.-G.); Detroit Medical Centre, Detroit, MI (N.P., S.A., A.O.B.); MedStar Washington Hospital Center, Washington, DC (A.C.); UPMC Shadyside, Pittsburgh, PA (K.M.); and Cedar-Sinai Medical Center, Los Angeles, CA (A.R.).From the Staten Island University Hospital, Staten Island, NY (N.J.P., N.S., V.P., J.L., M.K.); University of Arkansas, Little Rock (A.D., S.P., J.L.M., H.P.); University of Miami Miller School of Medicine, Miami, FL (V.S., G.T.S., R.D.M., J.F.V.-G.); Detroit Medical Centre, Detroit, MI (N.P., S.A., A.O.B.); MedStar Washington Hospital Center, Washington, DC (A.C.); UPMC Shadyside, Pittsburgh, PA (K.M.); and Cedar-Sinai Medical Center, Los Angeles, CA (A.R.).From the Staten Island University Hospital, Staten Island, NY (N.J.P., N.S., V.P., J.L., M.K.); University of Arkansas, Little Rock (A.D., S.P., J.L.M., H.P.); University of Miami Miller School of Medicine, Miami, FL (V.S., G.T.S., R.D.M., J.F.V.-G.); Detroit Medical Centre, Detroit, MI (N.P., S.A., A.O.B.); MedStar Washington Hospital Center, Washington, DC (A.C.); UPMC Shadyside, Pittsburgh, PA (K.M.); and Cedar-Sinai Medical Center, Los Angeles, CA (A.R.).From the Staten Island University Hospital, Staten Island, NY (N.J.P., N.S., V.P., J.L., M.K.); University of Arkansas, Little Rock (A.D., S.P., J.L.M., H.P.); University of Miami Miller School of Medicine, Miami, FL (V.S., G.T.S., R.D.M., J.F.V.-G.); Detroit Medical Centre, Detroit, MI (N.P., S.A., A.O.B.); MedStar Washington Hospital Center, Washington, DC (A.C.); UPMC Shadyside, Pittsburgh, PA (K.M.); and Cedar-Sinai Medical Center, Los Angeles, CA (A.R.).From the Staten Island University Hospital, Staten Island, NY (N.J.P., N.S., V.P., J.L., M.K.); University of Arkansas, Little Rock (A.D., S.P., J.L.M., H.P.); University of Miami Miller School of Medicine, Miami, FL (V.S., G.T.S., R.D.M., J.F.V.-G.); Detroit Medical Centre, Detroit, MI (N.P., S.A., A.O.B.); MedStar Washington Hospital Center, Washington, DC (A.C.); UPMC Shadyside, Pittsburgh, PA (K.M.); and Cedar-Sinai Medical Center, Los Angeles, CA (A.R.).From the Staten Island University Hospital, Staten Island, NY (N.J.P., N.S., V.P., J.L., M.K.); University of Arkansas, Little Rock (A.D., S.P., J.L.M., H.P.); University of Miami Miller School of Medicine, Miami, FL (V.S., G.T.S., R.D.M., J.F.V.-G.); Detroit Medical Centre, Detroit, MI (N.P., S.A., A.O.B.); MedStar Washington Hospital Center, Washington, DC (A.C.); UPMC Shadyside, Pittsburgh, PA (K.M.); and Cedar-Sinai Medical Center, Los Angeles, CA (A.R.).

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24842943

Citation

Patel, Nileshkumar J., et al. "Contemporary Trends of Hospitalization for Atrial Fibrillation in the United States, 2000 Through 2010: Implications for Healthcare Planning." Circulation, vol. 129, no. 23, 2014, pp. 2371-9.
Patel NJ, Deshmukh A, Pant S, et al. Contemporary trends of hospitalization for atrial fibrillation in the United States, 2000 through 2010: implications for healthcare planning. Circulation. 2014;129(23):2371-9.
Patel, N. J., Deshmukh, A., Pant, S., Singh, V., Patel, N., Arora, S., Shah, N., Chothani, A., Savani, G. T., Mehta, K., Parikh, V., Rathod, A., Badheka, A. O., Lafferty, J., Kowalski, M., Mehta, J. L., Mitrani, R. D., Viles-Gonzalez, J. F., & Paydak, H. (2014). Contemporary trends of hospitalization for atrial fibrillation in the United States, 2000 through 2010: implications for healthcare planning. Circulation, 129(23), 2371-9. https://doi.org/10.1161/CIRCULATIONAHA.114.008201
Patel NJ, et al. Contemporary Trends of Hospitalization for Atrial Fibrillation in the United States, 2000 Through 2010: Implications for Healthcare Planning. Circulation. 2014 Jun 10;129(23):2371-9. PubMed PMID: 24842943.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Contemporary trends of hospitalization for atrial fibrillation in the United States, 2000 through 2010: implications for healthcare planning. AU - Patel,Nileshkumar J, AU - Deshmukh,Abhishek, AU - Pant,Sadip, AU - Singh,Vikas, AU - Patel,Nilay, AU - Arora,Shilpkumar, AU - Shah,Neeraj, AU - Chothani,Ankit, AU - Savani,Ghanshyambhai T, AU - Mehta,Kathan, AU - Parikh,Valay, AU - Rathod,Ankit, AU - Badheka,Apurva O, AU - Lafferty,James, AU - Kowalski,Marcin, AU - Mehta,Jawahar L, AU - Mitrani,Raul D, AU - Viles-Gonzalez,Juan F, AU - Paydak,Hakan, Y1 - 2014/05/19/ PY - 2014/5/21/entrez PY - 2014/5/21/pubmed PY - 2014/8/15/medline KW - atrial fibrillation KW - cost KW - hospitalization SP - 2371 EP - 9 JF - Circulation JO - Circulation VL - 129 IS - 23 N2 - BACKGROUND: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. The associated morbidity and mortality make 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 the trends of AF-related hospitalizations in the United States and to compare patient characteristics, outcomes, and comorbid diagnoses. METHODS AND RESULTS: With the use of the Nationwide Inpatient Sample from 2000 through 2010, we identified AF-related hospitalizations using International Classification of Diseases, 9th Revision, Clinical Modification code 427.31 as the principal discharge diagnosis. Overall AF hospitalizations increased by 23% from 2000 to 2010, particularly in patients ≥65 years of age. The most frequent coexisting conditions were hypertension (60.0%), diabetes mellitus (21.5%), and chronic pulmonary disease (20.0%). Overall in-hospital mortality was 1%. The mortality rate was highest in the group of patients ≥80 years of age (1.9%) and in the group of 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 length of stay, mean cost of AF hospitalization increased significantly from $6410 in 2001 to $8439 in 2010 (24.0% increase; P<0.001). CONCLUSIONS: Hospitalization rates for AF have increased exponentially among US adults from 2000 to 2010. The 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. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/24842943/Contemporary_trends_of_hospitalization_for_atrial_fibrillation_in_the_United_States_2000_through_2010:_implications_for_healthcare_planning_ L2 - https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.114.008201?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -