Rates and implications for hospitalization of patients <65 years of age with atrial fibrillation/flutter

Gerald Naccarelli, Stephen S. Johnston, Mehul Dalal, Jay Lin, Parag P. Patel

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

The responsibility of managing atrial fibrillation (AF) and atrial flutter (AFL) falls predominantly on the Medicare system. Patients with AF or AFL often have a range of cardiovascular (CV) co-morbidities and are frequently hospitalized for AF and other CV causes. The present retrospective cohort study used medical claims data to evaluate the rates of hospitalization and inpatient mortality in elderly (aged <65 years) patients with AF or AFL with Medicare supplemental insurance. The data were extracted from the United States Thomson Reuters MarketScan Medicare Supplemental and Coordination of Benefits Database (January 2004 to December 2007). Patients aged <65 years with <1 inpatient or <2 outpatient nondiagnostic claims for AF or AFL and <12 months of continuous enrollment before their index AF or AFL diagnoses were identified. The frequencies of hospitalization and inpatient death were evaluated over the postindex study period (mean 24.3 months). Of an eligible study population of 55,774 patients with AF or AFL (mean age 77.9 years, 52.2% men), 28,939 patients (51.9%) were hospitalized (all causes) with nonfatal outcomes, 12,652 (22.7%) were rehospitalized, and 1,592 (2.9%) died in the hospital. Higher proportions of patients were hospitalized for non-CV than for CV causes (35.6% vs 27.2%). For CV hospitalizations culminating in inpatient death (n = 516), the most common admission diagnoses were major bleeding, stroke or transient ischemic attack, and congestive heart failure. In conclusion, elderly patients with AF or AFL undergo frequent hospitalization for CV and non-CV causes. Measures that lower inpatient admission rates, particularly readmission rates, may reduce the increasing cost of treating patients with AF or AFL with Medicare supplemental insurance.

Original languageEnglish (US)
Pages (from-to)543-549
Number of pages7
JournalAmerican Journal of Cardiology
Volume109
Issue number4
DOIs
StatePublished - Feb 15 2012

Fingerprint

Atrial Flutter
Atrial Fibrillation
Hospitalization
Inpatients
Medicare
Insurance
Transient Ischemic Attack
Cohort Studies
Outpatients
Heart Failure
Retrospective Studies
Stroke
Databases
Hemorrhage
Morbidity
Costs and Cost Analysis
Mortality

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Naccarelli, Gerald ; Johnston, Stephen S. ; Dalal, Mehul ; Lin, Jay ; Patel, Parag P. / Rates and implications for hospitalization of patients <65 years of age with atrial fibrillation/flutter. In: American Journal of Cardiology. 2012 ; Vol. 109, No. 4. pp. 543-549.
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Rates and implications for hospitalization of patients <65 years of age with atrial fibrillation/flutter. / Naccarelli, Gerald; Johnston, Stephen S.; Dalal, Mehul; Lin, Jay; Patel, Parag P.

In: American Journal of Cardiology, Vol. 109, No. 4, 15.02.2012, p. 543-549.

Research output: Contribution to journalArticle

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