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. 2014 Feb;127(2):158.e1-7.
doi: 10.1016/j.amjmed.2013.10.005. Epub 2013 Oct 16.

The impact of age on the epidemiology of atrial fibrillation hospitalizations

Sahar Naderi  1 , Yun Wang  2 , Amy L Miller  3 , Fátima Rodriguez  4 , Mina K Chung  1 , Martha J Radford  5 , Joanne M Foody  6
Affiliations

The impact of age on the epidemiology of atrial fibrillation hospitalizations

Sahar Naderi et al. Am J Med. 2014 Feb.

Abstract

Background: Given that 4 million individuals in the United States have atrial fibrillation, understanding the epidemiology of this disease is crucial. We sought to identify and characterize the impact of age on national atrial fibrillation hospitalization patterns.

Methods: The study sample was drawn from the 2009-2010 Nationwide Inpatient Sample. Patients hospitalized with a principal International Classification of Diseases, 9th Revision discharge diagnosis of atrial fibrillation were included. Patients were categorized as "older" (≥65 years) or "younger" (<65 years) for the purposes of analysis. The outcomes measured included hospitalization rate, length of stay, in-hospital mortality, and discharge status.

Results: We identified 192,846 atrial fibrillation hospitalizations. There was significant geographic variation in hospitalizations for both younger and older age groups. States with high hospitalizations differed from those states known to have high stroke mortality. Younger patients (33% of the sample) were more likely to be obese (21% vs 8%, P < .001) and to use alcohol (8% vs 2%, P < .001). Older patients were more likely to have kidney disease (14% vs 7%, P < .001). Both age groups had high rates of hypertension and diabetes. Older patients had higher in-hospital mortality and were more likely to be discharged to a nursing or intermediate care facility.

Conclusions: Younger patients account for a substantial minority of atrial fibrillation hospitalizations in contemporary practice. Younger patients are healthier, with a different distribution of risk factors, than older patients who have higher associated morbidity and mortality.

Keywords: Age; Atrial fibrillation; Epidemiology.

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Conflict of interest statement

Sahar Naderi, MD MHS: no conflicts of interest

Yun Wang, PhD: no conflicts of interest

Amy L. Miller, MD PhD: no conflicts of interest

Fátima Rodriguez, MD MPH: no conflicts of interest

Mina K. Chung, MD: no conflicts of interest

Martha J. Radford, MD: no conflicts of interest

JoAnne M. Foody, MD: no conflicts of interest

Figures

Figure 1
Figure 1
Atrial Fibrillation Hospitalization Rates * Results based on calculating the proportion of the US population in each age group hospitalized with Atrial Fibrillation. US population based on US census data for each age group.
Figure 2
Figure 2
Atrial Fibrillation Hospitalization Rates by State (per 100,000 person-years) for A) Younger Patients versus B) Older Patients * Indicates states classically included in the stroke belt
Figure 3
Figure 3
Difference in Atrial Fibrillation Hospitalization Rates (Per 100,000 person years) By State and Region between Younger and Older Patients
See this image and copyright information in PMC

References

    1. Camm J. Atrial fibrillation--an end to the epidemic? Circulation. 2005;112:iii. - PubMed
    1. Risk factors for stroke and efficacy of antithrombotic therapy in atrial fibrillation. Analysis of pooled data from five randomized controlled trials. Arch Intern Med. 1994;154:1449–1457. - PubMed
    1. Benjamin EJ, Wolf PA, D’Agostino RB, et al. Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation. 1998;98:946–952. - PubMed
    1. Go AS, Hylek EM, Phillips KA, et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA: the journal of the American Medical Association. 2001;285:2370–2375. - PubMed
    1. Kim MH, Johnston SS, Chu BC, et al. Estimation of total incremental health care costs in patients with atrial fibrillation in the United States. Circ Cardiovasc Qual Outcomes. 2011;4:313–320. - PubMed