Incidence and prevalence of atrial fibrillation and associated mortality among Medicare beneficiaries, 1993-2007.
Incidence and prevalence of atrial fibrillation and associated mortality among Medicare beneficiaries, 1993-2007.
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DOI：
10.1161/circoutcomes.111.962688
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发表时间：
2012-01
期刊：
影响因子：
--
通讯作者：
Curtis LH
中科院分区：
文献类型：
--
作者：
Piccini JP;Hammill BG;Sinner MF;Jensen PN;Hernandez AF;Heckbert SR;Benjamin EJ;Curtis LH
心房纤颤（AF）是老年人中常见且费用高昂的问题。房颤的频率随着年龄的增长而增加，但关于发病率和患病率的代表性国家数据有限。我们研究了老年人房颤的年发病率、患病率和死亡率。在1993年至2007年诊断为AF的65岁及以上医疗保险受益人的回顾性队列研究中，我们测量了AF的年年龄和性别校正发病率和患病率以及AF诊断后的死亡率。在433，123例房颤患者中，平均年龄为80岁，55%为女性，92%为白色。在14年的研究期间，AF的发生率保持稳定，范围为27.3 - 28.3/1000人-年。男性和白色受益人的发病率始终较高。在整个研究期间，AF的患病率增加（平均每年5%），并且对敏感性分析具有鲁棒性。在2007年发生AF的受益人中，36%患有心力衰竭，84%患有高血压，30%患有脑血管疾病，8%患有痴呆症。房颤诊断后的死亡率随时间略有下降，但仍然很高。2007年，年龄和性别调整后的死亡率在30天为11%，1年为25%。在老年医疗保险受益人中，AF事件很常见，十多年来一直保持相对稳定。AF事件与重大合并症和死亡率相关;四分之一的受益人在1年内死亡。
Atrial fibrillation (AF) is a common and costly problem among older persons. The frequency of AF increases with age, but representative national data about incidence and prevalence are limited. We examined the annual incidence, prevalence, and mortality associated with AF among older persons. In a retrospective cohort study of Medicare beneficiaries 65 years and older diagnosed with AF between 1993 and 2007, we measured annual age- and sex-adjusted incidence and prevalence of AF and mortality following an AF diagnosis. Among 433,123 patients with incident AF, the mean age was 80 years, 55% were women, and 92% were white. The incidence of AF remained steady during the 14-year study period, ranging from 27.3 to 28.3 per 1000 person-years. Incidence rates were consistently higher among men and white beneficiaries. The prevalence of AF increased across the study period (mean, 5% per year) and was robust to sensitivity analyses. Among beneficiaries with incident AF in 2007, 36% had heart failure, 84% had hypertension, 30% had cerebrovascular disease, and 8% had dementia. Mortality after AF diagnosis declined slightly over time but remained high. In 2007, the age- and sex-adjusted mortality rates were 11% at 30 days and 25% at 1 year. Among older Medicare beneficiaries, incident AF is common and has remained relatively stable for more than a decade. Incident AF is associated with significant comorbidity and mortality; death occurs in one-quarter of beneficiaries within 1 year.