Increasing trends in hospitalization for atrial fibrillation in the United States, 1985 through 1999: implications for primary prevention.
BACKGROUND
Atrial fibrillation, the most common sustained disturbance of heart rhythm, is associated with a 5-fold increase in the incidence of ischemic stroke.


RESULTS
The National Hospital Discharge Survey was used to estimate the annual number and prevalence of hospitalizations with atrial fibrillation among men and women 35 years of age or older. From 1985 through 1999, hospitalizations increased from 154 086 to 376 487 for a first-listed diagnosis and from 787 750 to 2 283 673 for any diagnosis. Prevalence was higher among successive age groups. Age-standardized prevalence was consistently higher among men than women. In 1999, essential hypertension, ischemic heart disease, congestive heart failure, and diabetes were prominent coexisting conditions. The number of male patients discharged home decreased from 77% to 63%, whereas the number of discharges to long-term care increased from 9% to 15%; the corresponding values for women were 72% to 56% and 15% to 23%. A slight increase in discharges to short-term care was indicated, whereas no trends were noted for in-hospital mortality.


CONCLUSIONS
Hospitalizations for atrial fibrillation have increased dramatically (2- to 3-fold) in recent years. The public health burden of atrial fibrillation is enormous and expected to continue to increase over the next decades. Primary prevention of atrial fibrillation must be recognized and pursued as a complementary management strategy for reducing cardiovascular morbidity and mortality.
Wattigney
Wendy A
WA
Division of Health Studies, Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop E-31, Atlanta, Ga 30333, USA. wdw0@cdc.gov
Mensah
George A
GA
Croft
Janet B
JB
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000628:therapy*; D015897:Comorbidity; D003710:Demography; D005260:Female; D019538:Health Care Surveys / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000639:trends*; D006333:Heart Failure / Q000453:epidemiology; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D017202:Myocardial Ischemia / Q000453:epidemiology; D011014:Pneumonia / Q000453:epidemiology; D015995:Prevalence; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology