Background: Atrial fibrillation (AF) is highly prevalent in patients with end-stage renal disease (ESRD). The clinical and economic burden of AF-associated hospitalizations has not been previously quantified in the ESRD population in the United States.
Objective: The aim of this study was to assess the incidence and outcomes of AF hospitalizations in the US ESRD population.
Methods: We used the 2003-2012 National Inpatient Sample database to study trends in the incidence and outcomes of AF hospitalizations in ESRD patients. Primary outcomes included hospitalization rate, in-hospital case fatality ratio (CFR), length of stay (LOS), and cost.
Results: There were 66,811 primary and 986,742 secondary AF hospitalizations associated with ESRD. The mean age of the patients was 70.9 years, and 45.2% were women. The age-adjusted primary AF hospitalization rate increased from 10.1 to 14.0 per 1000 ESRD patients, while the secondary AF hospitalization rate increased from 164.0 to 212.8 per 1000 ESRD patients (P-trend < 0.05 for both). There was a significant decrease in CFR (2.9%-2.7% for primary AF and 11.3%-7.7% for secondary AF; P-trend < .001 for both), mean LOS (6.0-4.8 days for primary AF and 9.8-7.1 days for secondary AF; P-trend < .001 for both), and mean cost ($14,395-$11,184 for primary AF and $25,545-$17,879 for secondary AF; P-trend < .001 for both).
Conclusion: There was a greater than 2-fold increase in the annual number of AF hospitalizations along with a significant increase in AF hospitalization rate in the US ESRD population. There were significant improvements in markers of quality of care, including inhospital CFR, LOS, and cost.
Keywords: Atrial fibrillation; Dialysis; End-stage renal disease; Hospitalization; Outcomes research.
Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.