Cardiovascular and non-cardiovascular hospital admissions associated with atrial fibrillation: a Danish nationwide, retrospective cohort study

Abstract

ObjectiveTo examine the excess risk of hospitalisation in patients with incident atrial fibrillation (AF).DesignA nationwide, retrospective cohort study.SettingDenmark.ParticipantsData on all admissions in Denmark from 1997 to 2009 were collected from nationwide registries. After exclusion of subjects previously admitted for AF, data on 4 602 264 subjects and 10 779 945 hospital admissions contributed to the study.Primary and secondary outcome measuresAge-stratified and sex-stratified admission rates were calculated for cardiovascular and non-cardiovascular admissions. Temporal patterns of readmission, relative risk and duration of frequent types of admission were calculated.ResultsOf 10 779 945 hospital admissions, 729 088(6.8%) were associated with AF. Admissions for cardiovascular reasons after 1, 3 and 6 months occurred for 6.0, 14.3 and 28.4% of AF patients versus 0.2, 0.6 and 1.8 of non-AF patients. Admissions for non-cardiovascular reasons after 1, 3 and 6 months comprised 6.8, 16.1 and 33.3% of AF patients and 1.2, 3.2 and 9.7% of non-AF patients. When stratified for age, AF was associated with similar cardiovascular admission rates across all age groups, while non-cardiovascular admission rates were higher in older patients. Within each age group and for both cardiovascular and non-cardiovascular admissions, AF was associated with higher rates of admission. When adjusted for age, sex and time period, patients with AF had a relative risk of 8.6 (95% CI 8.5 to 8.6) for admissions for cardiovascular reasons and 4.0 (95% CI 4.0 to 4.0) for admission for non-cardiovascular reasons.ConclusionsThis study confirms that the burden of AF is considerable and driven by both cardiovascular and non-cardiovascular admissions. These findings underscore the importance of using clinical and pharmacological means to reduce the hospital burden of AF in Western healthcare systems.

Overcoming reporting challenges: How to display, summarize, and model late reintervention outcomes, follow-up, and vital status information after surgery for atrial fibrillation

“…[25][26][27] In adjusted analyses, one may compare admission and readmission rates over time or across healthcare providers or geographic areas. In the current healthcare sector climate, methods such as those presented will provide intuitive and efficient ways to account for complex financial and socioeconomic factors that are relevant in the decisionmaking and resource utilization process.…”

Impact of Atrial Fibrillation on Healthcare Utilization in the Community: The Atherosclerosis Risk in Communities Study

“…A Danish nationwide study reported that, within each age group, hospitalization rates for CVD and non‐CVD admissions were higher among those with AF compared with those without AF. 27 Furthermore, a 30‐year follow‐up of Olmsted County, Minnesota, residents diagnosed with lone AF, considered to be purely an electrical conduction problem, revealed that those with AF had a slightly elevated risk of developing HF or a cerebrovascular event compared with the age‐ and sex‐matched Minnesota population. 28 Moreover, in a contemporary anticoagulated AF population, 90% of deaths were related to reasons other than stroke, 29 corroborating the impact of cardiovascular comorbidities on mortality reported from the AFFIRM trial 30 and the Atrial Fibrillation and Congestive Heart Failure (AF‐CHF) trial.…”

Patients With Atrial Fibrillation in Multidisciplinary Hospital: Structure of Hospitalization, Concomitant Cardiovascular Diseases and Drug Treatment (Data of Recvasa Af-Tula Registry)

“…По данным исследования РЕКВАЗА ФП-Тула выявлено, что больные с ФП составили 4,2% от числа госпитализированных в многопрофильный стационар. Это существенно выше, чем в популяции (1-2%), но значительно меньше, чем среди больных ССЗ, обращающихся в поликлиники (в среднем 10-20%) [1][2][3][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23].…”

“…Наибольшее число больных с ФП было выявлено в отделениях терапевтического профиля, максимальной их доля была в обоих кардиологических отделениях. Возрастной состав пациентов с ФП -люди преимущественно пожилого возраста (84,8% пациентов были старше 60 лет), что сходно с данными других госпитальных регистров [14,21,22,24].…”

“…в условиях многопрофильного стационара, изучены недостаточно [8,9]. Изучить структуру сочетанных ССЗ у больных с ФП, а также оценить качество лечения данной категории пациентов в реальной клинической практике позволяет создание регистров больных с ФП [9,[10][11][12][13][14][15][16].…”