title: The impact of age on the epidemiology of atrial fibrillation hospitalizations.
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.
authors: Cleveland Clinic Foundation, Heart and Vascular Institute, Cleveland, Ohio.
authors: Sahar
authors: S
authors: Naderi
authors: Department of Biostatistics, Harvard School of Public Health, Boston, Mass.
authors: Yun
authors: Y
authors: Wang
authors: Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Mass.
authors: Amy L
authors: AL
authors: Miller
authors: Department of Medicine, Brigham and Women's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass.
authors: Fátima
authors: F
authors: Rodriguez
authors: Cleveland Clinic Foundation, Heart and Vascular Institute, Cleveland, Ohio.
authors: Mina K
authors: MK
authors: Chung
authors: Department of Medicine, NYU School of Medicine, New York, NY.
authors: Martha J
authors: MJ
authors: Radford
authors: Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Mass. Electronic address: jfoody@partners.org.
authors: Joanne M
authors: JM
authors: Foody
mesh_terms: D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications / Q000453:epidemiology* / Q000401:mortality; D015897:Comorbidity; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D014481:United States / Q000453:epidemiology
keywords: Age; Atrial fibrillation; Epidemiology