The impact of atrial fibrillation on the cost of stroke: the berlin acute stroke study.
OBJECTIVE
Atrial fibrillation (AF) is an important risk factor for stroke. The primary purpose of this study was to determine the resource use for patients admitted to hospital with acute stroke and to calculate stroke-related direct costs, stratifying the results according to the presence of AF as a risk factor.


METHODS
Data from 558 consecutive patients hospitalized with confirmed acute stroke between August 2000 and July 2001 were analyzed as part of the Berlin Acute Stroke Study. Sociodemographic variables were assessed by direct interview, while hospital data were derived from patient medical records. Patients or their carers completed a follow-up questionnaire about resource utilization and absenteeism from work during the 12-month period after hospital admission.


RESULTS
Out of the 367 patients with follow-up data and ECG findings, 71 (19%) had AF. Patients with AF were generally older, more likely to be female, and had more severe strokes compared with those without AF. Mean direct costs per patient were significantly higher in those with AF-related strokes (EURO 11,799 vs EURO 8817 for non-AF-related strokes; P < 0.001). After adjustment for confounding factors, direct costs were comparable in the two groups, except for acute hospitalization costs, which remained significantly higher in the group with AF (P < 0.05).


CONCLUSIONS
Medical care for stroke patients with AF is associated with higher costs compared with those without AF; this is explained mainly by confounding factors and driven essentially by a significant difference in acute hospitalization costs.
Brüggenjürgen
Bernd
B
Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Germany.
Rossnagel
Karin
K
Roll
Stephanie
S
Andersson
Fredrik L
FL
Selim
Dagmar
D
Müller-Nordhorn
Jacqueline
J
Nolte
Christian H
CH
Jungehülsing
Gerhard J
GJ
Villringer
Arno
A
Willich
Stefan N
SN
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications* / Q000191:economics; D001604:Berlin; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003710:Demography; D005260:Female; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data*; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006786:Hospitals, Urban / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D012923:Social Class; D020521:Stroke / Q000191:economics* / Q000209:etiology; D011795:Surveys and Questionnaires