Abstract

Introduction: Socioeconomic status (SES) and race is closely interlinked. There is limited data regarding trends of atrial fibrillation (AF) hospitalizations in black and non-black adults based on SES. Methods: We queried the National Inpatient Sample database from January 2004 to December 2018 to identify patients admitted with AF. We used ICD-9-CM and ICD-10-CM diagnosis codes to identify all patients who were ≥18 years of age and hospitalized with a primary discharge diagnosis of AF. Our cohort was categorized into black and non-black groups, and SES using median household income (MHI) as a surrogate, into low SES (MHI 0-50) and high SES (MHI 51-100). AF hospitalizations per 1 million US population were calculated using US census population ≥18 years of age for each year. We estimated AF hospitalizations per 1 million blacks and non-blacks and trends in AF hospitalizations of black and non-black adults stratified by SES utilizing MHI. Cochran Armitage Test was utilized to estimate temporal trends. Results: Total admissions for AF per 1 million adults in the US population has increased (Figure 1). Among patients hospitalized with AF, the proportion of black adults is increasing. In those of low SES, both black and non-black patients have had increases in AF hospitalizations. However, in those of high SES, non-black patients have had steady improvement while black patients have remained at about the same rate of hospitalizations from 2004 to 2018 (Figure 2). Conclusions: Trends of AF hospitalizations have increased or not improved in low and high MHI-SES black adults, respectively. Identifying causes of these health disparities can improve healthcare quality in black adults with AF.

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