Drivers of hospitalisation trends for non-valvular atrial fibrillation in Western Australia, 2000–2013

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Abstract

Objective
To determine if increasing hospitalisations for non-valvular atrial fibrillation (NVAF) in Western Australia (WA) was due to incident (first-ever) or repeat hospitalisations, an ageing population structure, changing procedural practice or a combination of these factors.

Methods
We conducted a longitudinal retrospective population study on all WA residents aged 25–94 years between 2000 and 2013, with a principal hospital discharge diagnosis of NVAF. Person-linked hospital morbidity and mortality records were used to measure annual rate ratios (RRs) and 95% confidence intervals (CIs) in the total and incident NVAF (25–94 years) hospitalisations, further stratified by sex and by age-specific standardised groups (25–44, 45–64, 65–75, 75–84, 85–94 years).

Results
There were 55,532 total hospitalisations for NVAF between 2000 and 2013, patient mean age 68.3 years, and 58% male. Annual age- and sex- standardised rates for total NVAF hospitalisation increased by 3.0%/year (RR 1.030; 95%CI; 1.028, 1.038), and in both men and women. The largest absolute increase in hospitalisation rate occurred in those aged 85–94 years (∆613/100,000 men and women combined). Incident NVAF hospitalisations showed a borderline decline of 0.5%/year (RR 0.99; 95%CI; 0.99, 1.0) with a statistically significant trend in women but not men. The rate of AF admissions associated with a catheter ablation increased by 13%/year (95%CI; 13.1%, 15.3%).

Conclusion
The increasing rates of total hospitalisation for NVAF is driven more by repeat than incident admissions, escalating hospitalisations in the very elderly, and more frequent interventional procedures. These drivers have major economic and healthcare planning implications.
Original languageEnglish
Pages (from-to)273-277
JournalInternational Journal of Cardiology
Volume276
DOIs
Publication statusPublished - 1 Feb 2018

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Western Australia
Atrial Fibrillation
Hospitalization
Confidence Intervals
Catheter Ablation
Hospital Mortality
Population
Retrospective Studies
Economics
Morbidity
Delivery of Health Care

Cite this

@article{0a61d80746334ff7986f8cc32a5ec8b9,
title = "Drivers of hospitalisation trends for non-valvular atrial fibrillation in Western Australia, 2000–2013",
abstract = "ObjectiveTo determine if increasing hospitalisations for non-valvular atrial fibrillation (NVAF) in Western Australia (WA) was due to incident (first-ever) or repeat hospitalisations, an ageing population structure, changing procedural practice or a combination of these factors.MethodsWe conducted a longitudinal retrospective population study on all WA residents aged 25–94 years between 2000 and 2013, with a principal hospital discharge diagnosis of NVAF. Person-linked hospital morbidity and mortality records were used to measure annual rate ratios (RRs) and 95{\%} confidence intervals (CIs) in the total and incident NVAF (25–94 years) hospitalisations, further stratified by sex and by age-specific standardised groups (25–44, 45–64, 65–75, 75–84, 85–94 years).ResultsThere were 55,532 total hospitalisations for NVAF between 2000 and 2013, patient mean age 68.3 years, and 58{\%} male. Annual age- and sex- standardised rates for total NVAF hospitalisation increased by 3.0{\%}/year (RR 1.030; 95{\%}CI; 1.028, 1.038), and in both men and women. The largest absolute increase in hospitalisation rate occurred in those aged 85–94 years (∆613/100,000 men and women combined). Incident NVAF hospitalisations showed a borderline decline of 0.5{\%}/year (RR 0.99; 95{\%}CI; 0.99, 1.0) with a statistically significant trend in women but not men. The rate of AF admissions associated with a catheter ablation increased by 13{\%}/year (95{\%}CI; 13.1{\%}, 15.3{\%}).ConclusionThe increasing rates of total hospitalisation for NVAF is driven more by repeat than incident admissions, escalating hospitalisations in the very elderly, and more frequent interventional procedures. These drivers have major economic and healthcare planning implications.",
keywords = "Atrial fibrillation, Incidence, Hospitalisation, Ablation",
author = "Courtney Weber and Joseph Hung and Siobhan Hickling and Ian Li and Brendan McQuillan and Tom Briffa",
year = "2018",
month = "2",
day = "1",
doi = "10.1016/j.ijcard.2018.09.047",
language = "English",
volume = "276",
pages = "273--277",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "Elsevier",

}

TY - JOUR

T1 - Drivers of hospitalisation trends for non-valvular atrial fibrillation in Western Australia, 2000–2013

AU - Weber, Courtney

AU - Hung, Joseph

AU - Hickling, Siobhan

AU - Li, Ian

AU - McQuillan, Brendan

AU - Briffa, Tom

PY - 2018/2/1

Y1 - 2018/2/1

N2 - ObjectiveTo determine if increasing hospitalisations for non-valvular atrial fibrillation (NVAF) in Western Australia (WA) was due to incident (first-ever) or repeat hospitalisations, an ageing population structure, changing procedural practice or a combination of these factors.MethodsWe conducted a longitudinal retrospective population study on all WA residents aged 25–94 years between 2000 and 2013, with a principal hospital discharge diagnosis of NVAF. Person-linked hospital morbidity and mortality records were used to measure annual rate ratios (RRs) and 95% confidence intervals (CIs) in the total and incident NVAF (25–94 years) hospitalisations, further stratified by sex and by age-specific standardised groups (25–44, 45–64, 65–75, 75–84, 85–94 years).ResultsThere were 55,532 total hospitalisations for NVAF between 2000 and 2013, patient mean age 68.3 years, and 58% male. Annual age- and sex- standardised rates for total NVAF hospitalisation increased by 3.0%/year (RR 1.030; 95%CI; 1.028, 1.038), and in both men and women. The largest absolute increase in hospitalisation rate occurred in those aged 85–94 years (∆613/100,000 men and women combined). Incident NVAF hospitalisations showed a borderline decline of 0.5%/year (RR 0.99; 95%CI; 0.99, 1.0) with a statistically significant trend in women but not men. The rate of AF admissions associated with a catheter ablation increased by 13%/year (95%CI; 13.1%, 15.3%).ConclusionThe increasing rates of total hospitalisation for NVAF is driven more by repeat than incident admissions, escalating hospitalisations in the very elderly, and more frequent interventional procedures. These drivers have major economic and healthcare planning implications.

AB - ObjectiveTo determine if increasing hospitalisations for non-valvular atrial fibrillation (NVAF) in Western Australia (WA) was due to incident (first-ever) or repeat hospitalisations, an ageing population structure, changing procedural practice or a combination of these factors.MethodsWe conducted a longitudinal retrospective population study on all WA residents aged 25–94 years between 2000 and 2013, with a principal hospital discharge diagnosis of NVAF. Person-linked hospital morbidity and mortality records were used to measure annual rate ratios (RRs) and 95% confidence intervals (CIs) in the total and incident NVAF (25–94 years) hospitalisations, further stratified by sex and by age-specific standardised groups (25–44, 45–64, 65–75, 75–84, 85–94 years).ResultsThere were 55,532 total hospitalisations for NVAF between 2000 and 2013, patient mean age 68.3 years, and 58% male. Annual age- and sex- standardised rates for total NVAF hospitalisation increased by 3.0%/year (RR 1.030; 95%CI; 1.028, 1.038), and in both men and women. The largest absolute increase in hospitalisation rate occurred in those aged 85–94 years (∆613/100,000 men and women combined). Incident NVAF hospitalisations showed a borderline decline of 0.5%/year (RR 0.99; 95%CI; 0.99, 1.0) with a statistically significant trend in women but not men. The rate of AF admissions associated with a catheter ablation increased by 13%/year (95%CI; 13.1%, 15.3%).ConclusionThe increasing rates of total hospitalisation for NVAF is driven more by repeat than incident admissions, escalating hospitalisations in the very elderly, and more frequent interventional procedures. These drivers have major economic and healthcare planning implications.

KW - Atrial fibrillation

KW - Incidence

KW - Hospitalisation

KW - Ablation

U2 - 10.1016/j.ijcard.2018.09.047

DO - 10.1016/j.ijcard.2018.09.047

M3 - Article

VL - 276

SP - 273

EP - 277

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

ER -