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Factors Associated With the Epidemic of Hospitalizations Due to Atrial Fibrillation
Study Questions:
What are the changing patterns of and factors associated with age- and gender-specific incidence of hospitalizations for atrial fibrillation (AF) among the Australian population between 1993 and 2007?
Methods:
This was a retrospective analysis using administrative coding data obtained through the Australian National Hospital Morbidity Dataset. Hospitalizations with a principal diagnosis of AF from 1993 to 2007 were identified. Data were reported in age groupings of <50, 50-59, 60-69, 70-79, and ≥80 years old. Trends in AF-related procedures were evaluated to determine their contribution to the burden of AF hospitalizations. Binomial regression models were used to assess annual time trends.
Results:
Over the 15-year follow-up period, 473,501 hospitalizations for AF were identified. As a percentage of all hospitalizations, AF increased by an estimated 4.0% per year. The incidence of hospitalizations was higher in older age groups for every year, and the proportion of patients hospitalized with AF and aged ≥ 80 years increased from 10% to 16% in men and from 25% to 34% in women. Electrophysiologic studies as a percentage of AF hospitalizations increased minimally, from 15% to 17% between 2000 to 2003; a similarly small increase was seen in ablation procedures from 9% to 11% between 2004 and 2007.
Conclusions:
There is an increasing age-specific incidence of hospitalizations for AF in this Australian cohort. Evolving procedural trends have contributed minimally to the increasing number of AF-associated hospitalizations.
Perspective:
Although the present analysis is restricted by the inherent limitations of retrospective analysis of administrative coding data, it does indicate the need for additional study into older patients with AF. Additional research may better elucidate the factors contributing to the growing burden of hospitalizations in an aging population and potentially inform the creation of systems that could avert potentially unnecessary hospitalizations.
Author(s):
Prashant Vaishnava, MD
Keywords: Australia, Hospitalization, Epidemics
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