Frequency, Trends, and Outcomes of Cerebrovascular Events Associated With Atrial Fibrillation Hospitalizations
Section snippets
Methods
The national inpatient sample (NIS) used for the present analysis is described earlier (URL: https://www.distributor.hcup-us.ahrq.gov/) (eMethod 1).3,7,8 This study was deemed exempt from Institutional Review Board approval due to the publicly available nature of the de-identified data. The NIS data pertaining to hospitalizations with AF as the primary or secondary diagnosis from January 1, 2005 through September 31, 2015 was utilized for the present analysis. The International Classification
Results
From 2005 to 2015, there were 36,457,323 (95.2%) AF hospitalizations without cerebrovascular events and 1,824,608 (4.8%) with cerebrovascular events (Table 1). Hospitalizations with cerebrovascular events had a higher mean age as compared to hospitalizations without cerebrovascular events (79 vs 76, p value <0.001). Additionally, AF hospitalizations with cerebrovascular events demonstrated a higher frequency of hospitalizations over 80 years of age compared to AF hospitalizations without
Discussion
In this largest study-to-date evaluating incidence of cerebrovascular stroke in AF hospitalizations, 4.8% of AF hospitalizations were associated with cerebrovascular events. The highest surge of AIS followed by AHS was observed. The trend of overall cerebrovascular events increased from 2005 to 2015, mainly contributed by the increased trends of AIS and AHS. The in-hospital mortality curtailed during the study period, however, it remained significantly higher in those with cerebrovascular
Authors’ Contributions
Rajkumar Doshi: Conceptualization, Methodology, Software, Formal analysis, Writing - Original Draft, Writing - Review & Editing, Supervision Devina Adalja: Conceptualization, Methodology, Writing - Original Draft, Writing - Review & Editing, Supervision Ashish Kumar: Conceptualization, Methodology, Software, Formal analysis, Writing - Original Draft, Writing - Review & Editing Mihir Dave: Conceptualization, Methodology, Software, Formal analysis, Writing - Original Draft, Writing - Review &
Disclosures
The authors have no conflicts of interest to disclose.
References (30)
- et al.
Prevalence of cardiovascular risk factors and financial burden in younger adults hospitalized with atrial fibrillation
Heart Lung
(2020) - et al.
Comparison of baseline characteristics and in-hospital outcomes in medicaid versus private insurance hospitalizations for atrial fibrillation
Am J Cardiol
(2019) - et al.
Trend in mortality after stroke with atrial fibrillation
Am J Med
(2007) - et al.
Long-term relationship between atrial fibrillation, multimorbidity and oral anticoagulant drug use
Mayo Clin Proc
(2019) - et al.
Left atrial appendage thrombus is not uncommon in patients with acute atrial fibrillation and a recent embolic event: a transesophageal echocardiographic study
J Am Coll Cardiol
(1995) - et al.
Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation
Ann Thorac Surg
(1996) - et al.
Meta-analysis of transcatheter closure versus medical therapy for patent foramen ovale in prevention of recurrent neurological events after presumed paradoxical embolism
JACC Cardiovasc Interv
(2012) - et al.
Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study
Circulation
(2014) - et al.
genetic predisposition, clinical risk factor burden, and lifetime risk of atrial fibrillation
Circulation
(2018) - et al.
Contemporary trends of hospitalization for atrial fibrillation in the United States, 2000 through 2010: implications for healthcare planning
Circulation
(2014)
Large-scale assessment of a smartwatch to identify atrial fibrillation
N Engl J Med
Atrial fibrillation as an independent risk factor for stroke: the Framingham Study
Stroke
Atrial fibrillation in patients with cryptogenic stroke
N Engl J Med
Adherence to methodological standards in research using the national inpatient sample
JAMA
Time trends in atrial fibrillation-associated stroke and premorbid anticoagulation
Stroke
Cited by (1)
Frequency, Trend, Predictors, and Impact of Gastrointestinal Bleeding in Atrial Fibrillation Hospitalizations
2021, American Journal of CardiologyCitation Excerpt :The total cost of each hospital stay was analyzed by merging NIS data with cost-to-charge ratio files available from the sponsor. We estimated the final cost by adjusting the cost for inflation according to the Consumer Price Index data released by the United States Government.7 Multivariable logistic regression was used to adjust the outcomes for confounders.
Funding: Dr. Saraschandra Vallabhajosyula is supported by the Clinical and Translational Science Award (CTSA) grant number UL1 TR000135 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH). Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NIH.
- #
Drs. Doshi and Adalja contributed equally in this manuscript as co-first authors.