Estimates of Current and Future Incidence and Prevalence of Atrial Fibrillation in the US Adult Population
Estimates of Current and Future Incidence and Prevalence of Atrial Fibrillation in the US Adult Population
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DOI：
10.1016/j.amjcard.2013.05.063
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发表时间：
2013-10-15
影响因子：
2.8
通讯作者：
Liu, Xianchen
中科院分区：
文献类型：
--
作者：
Colilla, Susan;Crow, Ann;Liu, Xianchen
已发表的研究对美国心房颤动 (AF) 诊断发病率和患病率的估计和预测高度不一致。尽管人们普遍认为，由于美国人口中老年人数量的增加，房颤的发病率和患病率正在增加，但对预期增长率的估计却存在很大差异。这些差异的原因包括研究设计、涵盖时间段、出生队列和时间效应的差异，以及由于诊断工具的使用增加和医疗保健意识的提高而导致房颤诊断的改进。本研究的目的是估计和预测到 2030 年美国确诊 AF 的发病率和患病率。本研究使用了 2001 年至 2008 年的大型健康保险索赔数据库，代表了 5% 的美国人口的不同地理位置。房颤发病率和患病率的趋势和增长率是通过动态年龄阶段队列模拟进展模型预测的，该模型包括未来患病率预测中所有确诊的房颤病例（无论后续治疗如何），以及预计本质上是慢性的病例。模型结果显示，房颤发病率将翻倍，从 2010 年的 120 万例增加到 2030 年的 260 万例。考虑到发病率的增加，房颤患病率预计将从 2010 年的 520 万例增加到 2030 年的 1210 万例。在确定性和概率敏感性分析中探讨了模型参数不确定性的影响。房颤发病率和复发率未来趋势的变化对慢性房颤患病率的预测影响最大。可以得出的结论是，从 2010 年到 2030 年，房颤的发病率和患病率可能会上升，但未来趋势的严重程度存在广泛的不确定性。 (C) 2013 Elsevier Inc. 保留所有权利。
Estimates and projections of diagnosed incidence and prevalence of atrial fibrillation (AF) in the United States have been highly inconsistent across published studies. Although it is generally acknowledged that AF incidence and prevalence are increasing due to growing numbers of older people in the U.S. population, estimates of the rate of expected growth have varied widely. Reasons for these variations include differences in study design, covered time period, birth cohort, and temporal effects, as well as improvements in AF diagnosis due to increased use of diagnostic tools and health care awareness. The objective of this study was to estimate and project the incidence and prevalence of diagnosed AF in the United States out to 2030. A large health insurance claims database for the years 2001 to 2008, representing a geographically diverse 5% of the U.S. population, was used in this study. The trend and growth rate in AF incidence and prevalence was projected by a dynamic age-period cohort simulation progression model that included all diagnosed AF cases in future prevalence projections regardless of follow-up treatment, as well as those cases expected to be chronic in nature. Results from the model showed that AF incidence will double, from 1.2 million cases in 2010 to 2.6 million cases in 2030. Given this increase in incidence, AF prevalence is projected to increase from 5.2 million in 2010 to 12.1 million cases in 2030. The effect of uncertainty in model parameters was explored in deterministic and probabilistic sensitivity analyses. Variability in future trends in AF incidence and recurrence rates has the greatest impact on the projected estimates of chronic AF prevalence. It can be concluded that both incidence and prevalence of AF are likely to rise from 2010 to 2030, but there exists a wide range of uncertainty around the magnitude of future trends. (C) 2013 Elsevier Inc. All rights reserved.