Increasing trends in hospitalisations due to atrial fibrillation in Australia from 1993 to 2013

Celine Gallagher, Jeroen M.L. Hendriks, Lynne Giles, Jonathan Karnon, Clarabelle Pham, Adrian D. Elliott, Melissa E. Middeldorp, Rajiv Mahajan, Dennis H. Lau, Prash Sanders, Christopher X. Wong

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective The aim of this study is to characterise hospitalisations due to atrial fibrillation (AF) compared with two other common cardiovascular conditions, myocardial infarction (MI) and heart failure (HF), in addition to the associated economic burden of these hospitalisations and contribution of AF-related procedures. Methods The primary outcome measure was the rate of increase of AF, MI and HF hospitalisations from 1993 to 2013. The rate of increase of AF-related procedures including cardioversion and ablation were also collected, in addition to direct costs associated with hospitalisations for each of these three conditions. Results AF hospitalisations increased 295% over the 21-year period to a total of 61 424 in 2013. In comparison, MI and HF hospitalisations increased by only 73% and 39%, respectively, over the same period. Considering population changes, there was an annual increase in AF hospitalisations of 5.2% (incidence rate ratio [IRR] 1.052; 95% CI 1.046 to 1.059; p<0.001). In contrast, there was a 2.2% increase per annum for MI (IRR 1.022; 95% CI 1.017 to 1.027; p<0.001) and negligible annual change for HF hospitalisations (IRR 1.000; 95% CI 0.997 to 1.002; p=0.78). Cardioversion and AF ablation increased by 10% and 26% annually, respectively. AF hospitalisation costs rose by 479% over the 21-year period, an increase that was more than double that of MI and HF. Conclusions The burden of AF hospitalisations continues to rise unabated. AF has now surpassed both MI and HF hospitalisations and represents a growing cost burden. New models of healthcare delivery are required to stem this growing healthcare burden.

LanguageEnglish
Pages1358-1363
Number of pages6
JournalHeart
Volume105
Issue number17
DOIs
Publication statusPublished - 1 Sep 2019

Keywords

  • ablation
  • atrial fibrillation
  • cardioversion
  • healthcare burden
  • hospitalisations

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Gallagher, C., Hendriks, J. M. L., Giles, L., Karnon, J., Pham, C., Elliott, A. D., ... Wong, C. X. (2019). Increasing trends in hospitalisations due to atrial fibrillation in Australia from 1993 to 2013. Heart, 105(17), 1358-1363. https://doi.org/10.1136/heartjnl-2018-314471
Gallagher, Celine ; Hendriks, Jeroen M.L. ; Giles, Lynne ; Karnon, Jonathan ; Pham, Clarabelle ; Elliott, Adrian D. ; Middeldorp, Melissa E. ; Mahajan, Rajiv ; Lau, Dennis H. ; Sanders, Prash ; Wong, Christopher X. / Increasing trends in hospitalisations due to atrial fibrillation in Australia from 1993 to 2013. In: Heart. 2019 ; Vol. 105, No. 17. pp. 1358-1363.
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abstract = "Objective The aim of this study is to characterise hospitalisations due to atrial fibrillation (AF) compared with two other common cardiovascular conditions, myocardial infarction (MI) and heart failure (HF), in addition to the associated economic burden of these hospitalisations and contribution of AF-related procedures. Methods The primary outcome measure was the rate of increase of AF, MI and HF hospitalisations from 1993 to 2013. The rate of increase of AF-related procedures including cardioversion and ablation were also collected, in addition to direct costs associated with hospitalisations for each of these three conditions. Results AF hospitalisations increased 295{\%} over the 21-year period to a total of 61 424 in 2013. In comparison, MI and HF hospitalisations increased by only 73{\%} and 39{\%}, respectively, over the same period. Considering population changes, there was an annual increase in AF hospitalisations of 5.2{\%} (incidence rate ratio [IRR] 1.052; 95{\%} CI 1.046 to 1.059; p<0.001). In contrast, there was a 2.2{\%} increase per annum for MI (IRR 1.022; 95{\%} CI 1.017 to 1.027; p<0.001) and negligible annual change for HF hospitalisations (IRR 1.000; 95{\%} CI 0.997 to 1.002; p=0.78). Cardioversion and AF ablation increased by 10{\%} and 26{\%} annually, respectively. AF hospitalisation costs rose by 479{\%} over the 21-year period, an increase that was more than double that of MI and HF. Conclusions The burden of AF hospitalisations continues to rise unabated. AF has now surpassed both MI and HF hospitalisations and represents a growing cost burden. New models of healthcare delivery are required to stem this growing healthcare burden.",
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Gallagher, C, Hendriks, JML, Giles, L, Karnon, J, Pham, C, Elliott, AD, Middeldorp, ME, Mahajan, R, Lau, DH, Sanders, P & Wong, CX 2019, 'Increasing trends in hospitalisations due to atrial fibrillation in Australia from 1993 to 2013', Heart, vol. 105, no. 17, pp. 1358-1363. https://doi.org/10.1136/heartjnl-2018-314471

Increasing trends in hospitalisations due to atrial fibrillation in Australia from 1993 to 2013. / Gallagher, Celine; Hendriks, Jeroen M.L.; Giles, Lynne; Karnon, Jonathan; Pham, Clarabelle; Elliott, Adrian D.; Middeldorp, Melissa E.; Mahajan, Rajiv; Lau, Dennis H.; Sanders, Prash; Wong, Christopher X.

In: Heart, Vol. 105, No. 17, 01.09.2019, p. 1358-1363.

Research output: Contribution to journalArticle

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T1 - Increasing trends in hospitalisations due to atrial fibrillation in Australia from 1993 to 2013

AU - Gallagher, Celine

AU - Hendriks, Jeroen M.L.

AU - Giles, Lynne

AU - Karnon, Jonathan

AU - Pham, Clarabelle

AU - Elliott, Adrian D.

AU - Middeldorp, Melissa E.

AU - Mahajan, Rajiv

AU - Lau, Dennis H.

AU - Sanders, Prash

AU - Wong, Christopher X.

PY - 2019/9/1

Y1 - 2019/9/1

N2 - Objective The aim of this study is to characterise hospitalisations due to atrial fibrillation (AF) compared with two other common cardiovascular conditions, myocardial infarction (MI) and heart failure (HF), in addition to the associated economic burden of these hospitalisations and contribution of AF-related procedures. Methods The primary outcome measure was the rate of increase of AF, MI and HF hospitalisations from 1993 to 2013. The rate of increase of AF-related procedures including cardioversion and ablation were also collected, in addition to direct costs associated with hospitalisations for each of these three conditions. Results AF hospitalisations increased 295% over the 21-year period to a total of 61 424 in 2013. In comparison, MI and HF hospitalisations increased by only 73% and 39%, respectively, over the same period. Considering population changes, there was an annual increase in AF hospitalisations of 5.2% (incidence rate ratio [IRR] 1.052; 95% CI 1.046 to 1.059; p<0.001). In contrast, there was a 2.2% increase per annum for MI (IRR 1.022; 95% CI 1.017 to 1.027; p<0.001) and negligible annual change for HF hospitalisations (IRR 1.000; 95% CI 0.997 to 1.002; p=0.78). Cardioversion and AF ablation increased by 10% and 26% annually, respectively. AF hospitalisation costs rose by 479% over the 21-year period, an increase that was more than double that of MI and HF. Conclusions The burden of AF hospitalisations continues to rise unabated. AF has now surpassed both MI and HF hospitalisations and represents a growing cost burden. New models of healthcare delivery are required to stem this growing healthcare burden.

AB - Objective The aim of this study is to characterise hospitalisations due to atrial fibrillation (AF) compared with two other common cardiovascular conditions, myocardial infarction (MI) and heart failure (HF), in addition to the associated economic burden of these hospitalisations and contribution of AF-related procedures. Methods The primary outcome measure was the rate of increase of AF, MI and HF hospitalisations from 1993 to 2013. The rate of increase of AF-related procedures including cardioversion and ablation were also collected, in addition to direct costs associated with hospitalisations for each of these three conditions. Results AF hospitalisations increased 295% over the 21-year period to a total of 61 424 in 2013. In comparison, MI and HF hospitalisations increased by only 73% and 39%, respectively, over the same period. Considering population changes, there was an annual increase in AF hospitalisations of 5.2% (incidence rate ratio [IRR] 1.052; 95% CI 1.046 to 1.059; p<0.001). In contrast, there was a 2.2% increase per annum for MI (IRR 1.022; 95% CI 1.017 to 1.027; p<0.001) and negligible annual change for HF hospitalisations (IRR 1.000; 95% CI 0.997 to 1.002; p=0.78). Cardioversion and AF ablation increased by 10% and 26% annually, respectively. AF hospitalisation costs rose by 479% over the 21-year period, an increase that was more than double that of MI and HF. Conclusions The burden of AF hospitalisations continues to rise unabated. AF has now surpassed both MI and HF hospitalisations and represents a growing cost burden. New models of healthcare delivery are required to stem this growing healthcare burden.

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Gallagher C, Hendriks JML, Giles L, Karnon J, Pham C, Elliott AD et al. Increasing trends in hospitalisations due to atrial fibrillation in Australia from 1993 to 2013. Heart. 2019 Sep 1;105(17):1358-1363. https://doi.org/10.1136/heartjnl-2018-314471