title: Trends in incidence and prevalence of hospitalization for atrial fibrillation and associated mortality in Western Australia, 1995-2010.
abstract: OBJECTIVE
  Hospitalization for atrial fibrillation (AF) is a large and growing public health problem. We examined current trends in the incidence, prevalence, and associated mortality of first-ever hospitalization for AF.
  
  
  METHODS
  Linked hospital admission data were used to identify all Western Australia residents aged 35-84 years with prevalent AF and incident (first-ever) hospitalization for AF as a principal or secondary diagnosis during 1995-2010.
  
  
  RESULTS
  There were 57,552 incident hospitalizations, mean age 69.8 years, with 41.4% women. Over the calendar periods, age- and sex-standardized incidence of hospitalization for AF as any diagnosis declined annually by 1.1% (95% CI; 0.93, 1.29), while incident AF as a principal diagnosis increased annually by 1.2% (95% CI; 0.84, 1.50). Incident AF hospitalization was higher among men than women, and 15-fold higher in the 75-84 compared with 35-64 year age group. The age- and sex-standardized prevalence of AF increased annually by 2.0% (95% CI; 1.88, 2.03) over the same period. Comorbidity trends were mixed with diabetes and valvular heart disease increasing, and hypertension, coronary artery disease, heart failure, cerebrovascular disease, and chronic kidney disease decreasing. The 1-year all-cause mortality after incident AF hospitalization declined from 17.6% to 14.6% (trend P<0.001), with an adjusted hazard ratio of 0.86 (95% CI; 0.81, 0.91).
  
  
  CONCLUSIONS
  This contemporary study shows that incident AF hospitalization is not increasing except for AF as a principal diagnosis, while population prevalence of hospitalized AF has risen substantially. The high 1-year mortality following incident AF hospitalization has improved only modestly over the recent period.
authors.affiliation: School of Population Health, The University of Western Australia, Crawley, Western Australia, Australia.
authors.forename: Tom
authors.initials: T
authors.lastname: Briffa
authors.affiliation: School of Medicine and Pharmacology, Sir Charles Gairdner Hospital Unit, The University of Western Australia, Crawley, Western Australia, Australia. Electronic address: joe.hung@uwa.edu.au.
authors.forename: Joseph
authors.initials: J
authors.lastname: Hung
authors.affiliation: School of Population Health, The University of Western Australia, Crawley, Western Australia, Australia.
authors.forename: Matthew
authors.initials: M
authors.lastname: Knuiman
authors.affiliation: School of Medicine and Pharmacology, Sir Charles Gairdner Hospital Unit, The University of Western Australia, Crawley, Western Australia, Australia.
authors.forename: Brendan
authors.initials: B
authors.lastname: McQuillan
authors.affiliation: School of Medicine, Flinders University of South Australia, Adelaide, South Australia, Australia.
authors.forename: Derek P
authors.initials: DP
authors.lastname: Chew
authors.affiliation: Department of Medicine, McMaster University, Hamilton, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Eikelboom
authors.affiliation: School of Population Health, The University of Western Australia, Crawley, Western Australia, Australia.
authors.forename: Graeme J
authors.initials: GJ
authors.lastname: Hankey
authors.affiliation: Western Australian Centre for Rural Health, The University of Western Australia, Crawley, Western Australia, Australia.
authors.forename: Tiew-Hwa K
authors.initials: TH
authors.lastname: Teng
authors.affiliation: School of Population Health, The University of Western Australia, Crawley, Western Australia, Australia.
authors.forename: Lee
authors.initials: L
authors.lastname: Nedkoff
authors.affiliation: Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia.
authors.forename: Rukshen
authors.initials: R
authors.lastname: Weerasooriya
authors.affiliation: Department of Cardiology, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Liu
authors.affiliation: Department of Cardiovascular Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Stobie
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000401:mortality*; D005260:Female; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D011159:Population Surveillance / Q000379:methods; D015995:Prevalence; D014904:Western Australia / Q000453:epidemiology
keywords: Atrial fibrillation; Hospitalization; Incidence; Mortality; Prevalence