Twenty-Year National Trends in Hospitalisations Due to Atrial Fibrillation in Australia: A Relentless Rise

Abstract

Background: Atrial fibrillation (AF) is a worldwide epidemic. We characterised trends in AF hospitalisations over a 20-year period in Australian hospitals, and compared these to two other common cardiovascular conditions, myocardial infarction (MI) and heart failure (HF). Methods: Data were obtained from the Australian Institute of Health and Welfare. Hospitalisations with a principal diagnosis of AF, MI or HF were extracted for 1993-2013. Time trends in the aggregate yearly number of AF, MI and HF hospitalisations were assessed using age- and gender-adjusted negative binomial regression models. All models included an offset term for the logarithm of the estimated midyear Australian population. Results: There was a 295% relative increase in AF hospitalisations to a total of 61,424 in 2013, representing a near doubling of AF hospitalisations since the beginning of this century. MI and HF hospitalisations increased by 73% and 39%, to a total of 54,116 and 53,643 respectively in 2013. Taking into account population changes, the annual increase in AF hospitalisations was 5.2% (incidence rate ratio [IRR] 1.052; 95% CI 1.046 - 1.059; p < 0.001). In contrast, MI hospitalisations increased 2.2% annually (IRR 1.022; 95% CI 1.017 – 1.027; p < 0.001) and negligible annual change for HF hospitalisations (IRR 1.000; 95% CI 0.997 – 1.002; p = 0.78). All age and gender categories demonstrated a significant increase in AF related hospitalisations over the 20-year period. Conclusions: AF related hospitalisations continue to demonstrate a relentless rise. This has significant implications for health care systems worldwide with new models of health care urgently needed to stem this rising tide.