title: Hospital costs associated with atrial fibrillation for patients with ischemic stroke aged 18-64 years in the United States.
abstract: OBJECTIVE
  Hospital costs associated with atrial fibrillation (AFib) among patients with stroke have not been well-studied, especially among people aged <65 years. We estimated the AFib-associated hospital costs in US patients aged 18 to 64 years.
  
  
  METHODS
  We identified hospital admissions with a primary diagnosis of ischemic stroke from the 2010 to 2012 MarketScan Commercial Claims and Encounters inpatient data sets, excluding those with capitated health insurance plans, aged <18 or >64 years, missing geographic region, hospital costs below the 1st or above 99th percentile, and having carotid intervention (n=40 082). We searched the data for AFib and analyzed the costs for nonrepeat and repeat stroke admissions separately. We estimated the AFib-associated costs using multivariate regression models controlling for age, sex, geographic region, and Charlson comorbidity index.
  
  
  RESULTS
  Of the 33 500 nonrepeat stroke admissions, 2407 (7.2%) had AFib. Admissions with AFib cost $4991 more than those without AFib ($23 770 versus $18 779). For the 6582 repeat stroke admissions, 397 (6.0%) had AFib. The costs were $3260 more for those with AFib than those without ($24 119 versus $20 929). After controlling for potential confounders, AFib-associated costs for nonrepeat stroke admissions were $4905, representing 20.6% of the total costs for the admissions. Both the hospital costs and the AFib-associated costs were associated with age, but not with sex. AFib-associated costs for repeat stroke admissions were not significantly higher than for non-AFib patients, except for those aged 55 to 64 years ($3537).
  
  
  CONCLUSIONS
  AFib increased the hospital cost of ischemic stroke substantially. Further investigation on AFib-associated costs for repeat stroke admissions is needed.
authors: From the Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA (G.W., X.T., M.G.G.); and IHRC Inc (H.J.), Atlanta, GA. Gbw9@cdc.gov.
authors: Guijing
authors: G
authors: Wang
authors: From the Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA (G.W., X.T., M.G.G.); and IHRC Inc (H.J.), Atlanta, GA.
authors: Heesoo
authors: H
authors: Joo
authors: From the Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA (G.W., X.T., M.G.G.); and IHRC Inc (H.J.), Atlanta, GA.
authors: Xin
authors: X
authors: Tong
authors: From the Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA (G.W., X.T., M.G.G.); and IHRC Inc (H.J.), Atlanta, GA.
authors: Mary G
authors: MG
authors: George
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001281:Atrial Fibrillation / Q000150:complications / Q000191:economics* / Q000628:therapy; D002545:Brain Ischemia / Q000150:complications / Q000191:economics* / Q000628:therapy; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D020521:Stroke / Q000150:complications / Q000191:economics* / Q000628:therapy; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: atrial fibrillation; hospital costs; stroke